Integrative Immunology Care PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

INTEGRATIVE IMMUNOLOGY CARE PLLC

Practice address

8810 Blakeney Professional Dr Ste 100
Charlotte, NC 28277-6596

Phone

(704) 910-1402

Fax

(704) 910-1506

NPI assigned

Sep 23, 2024

Organization subpart

No

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

Authorized official

Name

Maeve Oconnor

Title

Owner

Phone

(704) 910-1402

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727049600000",
    "number": "1063239044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8810 BLAKENEY PROFESSIONAL DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282776596",
            "telephone_number": "704-910-1402",
            "fax_number": "704-910-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8810 BLAKENEY PROFESSIONAL DR STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282776596",
            "telephone_number": "704-910-1402",
            "fax_number": "704-910-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE IMMUNOLOGY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A",
        "authorized_official_last_name": "OCONNOR",
        "authorized_official_first_name": "MAEVE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-910-1402"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.