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DLP Maria Parham Physician Practices LLC

Organization Active NPI Vascular Surgery Physician · Henderson, NC

NPI 1083197818 · NPPES record last updated Sep 7, 2018

Key facts

NPI
1083197818
Entity type
Organization (NPI type 2)
Primary specialty
Vascular Surgery Physician 2086S0129X
Legal business name
DLP MARIA PARHAM PHYSICIAN PRACTICES LLC
Practice address
566 Ruin Creek Rd
Henderson, NC 27536-2927
Phone
(252) 436-1055
NPI assigned
Sep 7, 2018
Organization subpart
No

Authorized official

Name
Sara L Miller
Title
Director
Phone
(615) 920-7780

Corporate family (same tax ID) 18

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
DLP Maria Parham Physician Practices LLC (19 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208600000X
Vascular Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 2086S0129X Yes
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP		 363A00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363L00000X

Addresses

Primary practice location

566 Ruin Creek Rd
Henderson, NC 27536-2927

Mailing address

330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000

Other names

  • Maria Parham Vein Clinic Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 7, 2018.

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536278400000",
    "number": "1083197818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275098",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "566 RUIN CREEK RD",
            "city": "HENDERSON",
            "state": "NC",
            "postal_code": "275362927",
            "telephone_number": "252-436-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DLP MARIA PARHAM PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-07",
        "last_updated": "2018-09-07",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-920-7780"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maria Parham Vein Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maria Parham Vein Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NC

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Sources for this page

Verify at the official NPI Registry.