Organization Active NPI

Doctors Vital Care and Screening, PLLC

  • Primary Care Clinic/Center
  • Sanford, NC
National Provider Identifier
1073712337
Registry record updated Dec 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
102462 Issued in NC
Legal business name
DOCTORS VITAL CARE AND SCREENING, PLLC
Practice address
150 N Steele St
Sanford, NC 27330-3918
Phone
(919) 776-7255
Fax
(919) 776-5011
NPI assigned
Jul 16, 2007
Last updated
Dec 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2011

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

Authorized official

Name
Mrs. Poonam Ajimani
Title
Office Manager
Phone
(919) 740-2864

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 102462 NC Primary

Addresses

Primary practice location

150 N Steele St
Sanford, NC 27330-3918

Mailing address

150 N Steele St
Sanford, NC 27330-3918
Phone (919) 776-7255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080515000209 NC Part B Supplier - Clinic/Group Practice 4082783188 Receives reassigned benefits from 1 practitioner
Practice locations: Chapel Hill, NC; Sanford, NC

National Provider Directory

National Provider Directory

Locations

11312 US 15 501 N
Ste 106
Chapel Hill, NC 27517
Phone (919) 533-4686

150 N Steele St
Sanford, NC 27330
Phone (919) 342-0108

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1184544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323648000000",
    "number": "1073712337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N STEELE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273303918",
            "telephone_number": "919-776-7255",
            "fax_number": "919-776-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N STEELE ST",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273303918",
            "telephone_number": "919-776-7255",
            "fax_number": "919-776-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTORS VITAL CARE AND SCREENING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-16",
        "last_updated": "2011-12-12",
        "status": "A",
        "authorized_official_last_name": "AJIMANI",
        "authorized_official_first_name": "POONAM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "919-740-2864",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NC",
            "license": "102462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.