Juan Carlos De Virgiliis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

28719 Issued in NC

Practice address

381 Deerfield Rd
Boone, NC 28607

Phone

(828) 262-3733

Fax

(828) 264-7799

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Total Integrated Health Services

  • Family Medicine Physician
  • Boone, NC
  • NPI 1548344344
  NPD (past) Authorized official

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268784000000",
    "number": "1053403246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "381 DEERFIELD RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "28607",
            "telephone_number": "828-297-1811",
            "fax_number": "828-264-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 DEERFIELD RD",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "28607",
            "telephone_number": "828-262-3733",
            "fax_number": "828-264-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VIRGILIIS",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2010-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "28719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8928376",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Savannah Sheets Davis, OD
• Walter Etchelles Davis, M.D
• Daymark Recovery Services Inc
• Daymark Recovery Services Inc
• Daymark Recovery Services Inc
• Tyler Allease Deal, LPCA, NCC
• Jaime Dean
• Alicia Angeline Debord, PT
• Amy Decamp
• David Louis Demeulemeester, RPH

• Family Medicine Physician in Boone, NC
• Providers in Boone, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.