Organization Active NPI

Bio-Lifecycle Medical Centers, PLLC

  • Public Health & General Preventive Medicine Physician
  • Raleigh, NC
National Provider Identifier
1003159617
Registry record updated Apr 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
39759 Issued in NC
Legal business name
BIO-LIFECYCLE MEDICAL CENTERS, PLLC
Practice address
4201 Lake Boone TRL
Ste 005
Raleigh, NC 27607-7512
Phone
(919) 851-9100
NPI assigned
Apr 2, 2013
Last updated
Apr 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2013

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

Authorized official

Name
Mike Montemurro
Title
Coo
Phone
(919) 851-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2083P0901X 39759 NC Primary

Addresses

Primary practice location

4201 Lake Boone TRL
Ste 005
Raleigh, NC 27607-7512

Mailing address

4201 Lake Boone TRL
Ste 005
Raleigh, NC 27607-7512
Phone (919) 851-9100

National Provider Directory

National Provider Directory

Locations

4201 Lake Boone Trl
Ste 5
Raleigh, NC 27607
Phone (919) 788-7760

NPI Registry JSON

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

{
    "created_epoch": "1364860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364860800000",
    "number": "1003159617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL",
            "address_2": "STE 005",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077512",
            "telephone_number": "919-851-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL",
            "address_2": "STE 005",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077512",
            "telephone_number": "919-851-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIO-LIFECYCLE MEDICAL CENTERS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-02",
        "last_updated": "2013-04-02",
        "status": "A",
        "authorized_official_last_name": "MONTEMURRO",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "919-851-9100"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "NC",
            "license": "39759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.