Imperial Healthcare Services

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

MD0000038183 Issued in TN

Legal business name

IMPERIAL HEALTHCARE SERVICES

Practice address

1604 Lamons LN Ste 230
Johnson City, TN 37604-8224

Phone

(423) 930-5168

Fax

(423) 328-0193

NPI assigned

Nov 4, 2010

Last updated

Nov 4, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Renee R Buckles, FNP

Title

Vice President

Phone

(423) 930-5168

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1288828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288828800000",
    "number": "1033410220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1604 LAMONS LN STE 230",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048224",
            "telephone_number": "423-930-5168",
            "fax_number": "423-328-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 LAMONS LN STE 230",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376048224",
            "telephone_number": "423-930-5168",
            "fax_number": "423-328-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-04",
        "last_updated": "2010-11-04",
        "status": "A",
        "authorized_official_last_name": "BUCKLES",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "423-930-5168",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TN",
            "license": "MD0000038183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dimka M Ialamova-Tountcheva, MD
• Lamis Wahid Ibrahim, M.D
• Mohd Awni Ibrahim, MBBS
• Zain Alabdin Ibrahim, MD
• Carrie B Illum
• Imperial Pain Specialists Inc
• Independent Living Solutions LLC
• Independent Physical Therapy
• Independent Physical Therapy
• Independent Physical Therapy LLC

• Primary Care Clinic/Center in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Primary Care Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.