NPIMap

Organization Active NPI

James D. Mickle Jr. MD

  • Clinic/Center
  • Boyertown, PA
National Provider Identifier
1003013244
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
MD016977E Issued in PA
Legal business name
JAMES D. MICKLE JR. MD
Practice address
137 Montgomery Ave
Suite 203
Boyertown, PA 19512-1300
Phone
(610) 369-2050
Fax
(610) 369-2710
NPI assigned
Jun 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. James D Mickle Jr., MD
Title
Owner
Phone
(610) 369-2050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X MD016977E PA Primary

Addresses

Primary practice location

137 Montgomery Ave
Suite 203
Boyertown, PA 19512-1300

Mailing address

137 Montgomery Ave
Suite 203
Boyertown, PA 19512-1300
Phone (610) 369-2050

Other names 1

  • Cholesterol Studies and Treatment Other name

National Provider Directory

National Provider Directory
Tax ID family
Cholesterol Studies and Treatment2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280361600000",
    "number": "1003013244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 MONTGOMERY AVE",
            "address_2": "SUITE 203",
            "city": "BOYERTOWN",
            "state": "PA",
            "postal_code": "195121300",
            "telephone_number": "610-369-2050",
            "fax_number": "610-369-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 MONTGOMERY AVE",
            "address_2": "SUITE 203",
            "city": "BOYERTOWN",
            "state": "PA",
            "postal_code": "195121300",
            "telephone_number": "610-369-2050",
            "fax_number": "610-369-2710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES D. MICKLE JR. MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2010-07-29",
        "status": "A",
        "authorized_official_last_name": "MICKLE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-369-2050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "PA",
            "license": "MD016977E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cholesterol Studies and Treatment",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boyertown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.