NPIMap

Organization Active NPI

Avalon Medical Group

Doing business as Avalon Internal Medicine

  • Family Medicine Physician
  • Chapel Hill, NC
National Provider Identifier
1033218045
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9700235 Issued in NC
Legal business name
AVALON MEDICAL GROUP
Doing business as
Avalon Internal Medicine
Practice address
101 Conner Dr
Ste 402
Chapel Hill, NC 27514-7038
Phone
(919) 928-1146
Fax
(919) 928-1148
NPI assigned
Sep 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2008

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

Authorized official

Name
Mr. Richard R Dilalla
Title
Practice Manager
Phone
(919) 928-1146

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 9700235 NC Primary

Addresses

Primary practice location

101 Conner Dr
Ste 402
Chapel Hill, NC 27514-7038

Mailing address

101 Conner Dr
Ste 402
Chapel Hill, NC 27514-7038

Other identifiers 2

IdentifierTypeStateIssuer
011P2OtherNCBC/BS
89011P2MedicaidNC

Other names 1

  • Avalon Internal Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

101 Conner Dr
Ste 402
Chapel Hill, NC 27514
Phone (919) 928-1146

Practitioners & affiliated clinicians

Practitioners 5

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": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1033218045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CONNER DR",
            "address_2": "STE 402",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275147038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CONNER DR",
            "address_2": "STE 402",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275147038",
            "telephone_number": "919-928-1146",
            "fax_number": "919-928-1148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "DILALLA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "919-928-1146",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "9700235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "011P2",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89011P2",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avalon Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2008; 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.