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DDMR PLLC NPI 1851692891


NPI Information

NPI: 1851692891
Provider Name: DDMR PLLC

Doing Business As: HEALTH SOURCE OF MONROE

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
1309 E SUNSET DR
MONROE, NC
ZIP 28112
Phone: (704) 296-9090
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DDMR PLLC is a clinic center in Monroe, NC. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). DDMR PLLC NPI is 1851692891. The provider is registered as an organization entity type.
The provider Is Doing Business As Health Source Of Monroe.

The provider's business location address is:

1309 E SUNSET DR
MONROE, NC
ZIP 28112-324
Phone: (704) 296-9090

The provider's authorized official is Michael Riccoboni .
The authorized official title is Organizing Member and has the following contact phone number (336) 766-5935.

The enumeration date for this NPI number is 11/8/2010 and was last updated on 11/8/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center3062NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11477587947OTHERNORTH CAROLINANPI
2U63851MEDICARE UPINNORTH CAROLINA
31013998848OTHERNORTH CAROLINANPI
4085HMMEDICAIDNORTH CAROLINA
52450746AMEDICARE PINNORTH CAROLINA
6890833WMEDICAIDNORTH CAROLINA
7U95430MEDICARE UPINNORTH CAROLINA
82456520MEDICARE PINNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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