Digitrace Care Services, Inc

Primary specialty

Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X

Legal business name

DIGITRACE CARE SERVICES, INC

Practice address

2060 N Valley Mills Dr
Waco, TX 76710-2561

Phone

(254) 741-0455

Fax

(254) 741-6968

NPI assigned

Jul 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Carl R. Iberger

Title

Evp,Cfo

Phone

(978) 536-7400

Specialties & licenses 2

Addresses

Other identifiers 6

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255564800000",
    "number": "1093745747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE PL",
            "address_2": "SUITE 5B",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019603840",
            "telephone_number": "978-536-7400",
            "fax_number": "978-535-9757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 N VALLEY MILLS DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102561",
            "telephone_number": "254-741-0455",
            "fax_number": "254-741-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGITRACE CARE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2009-10-15",
        "status": "A",
        "authorized_official_last_name": "IBERGER",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "EVP,CFO",
        "authorized_official_telephone_number": "978-536-7400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126657901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST CARE",
            "identifier": "103364101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "PL7236",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7618325",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0085DC",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "PL7237",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Hansen Dickie, M.D.
• Karen Lynn Dierolf, OTR, CHT
• Karleigh Dieterich, PT
• Kelsy Dieterich, CST/CSFA
• John Daly Dietrick, MD
• Marc Alan Dildy, CRNA
• Lauren Michelle Dillavou
• Savannah Grace Dillon, COTA
• Colby Dimond, D.D.S.
• Jessica Dine, APRN, FNP-BC

• Sleep Disorder Diagnostic Clinic/Center in Waco, TX
• Providers in Waco, TX by specialty
• Sleep Disorder Diagnostic Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; 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.