Intelligenetics, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

8038983432 Issued in SC

Legal business name

INTELLIGENETICS, LLC

Practice address

24 New Orleans Rd
Suite 100
Hilton Head, SC 29928-4721

Phone

(334) 819-4500

Fax

(334) 819-4520

NPI assigned

Mar 18, 2014

Organization subpart

No

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

Authorized official

Name

January Miller Green

Title

VP, HR

Phone

(334) 819-4500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1395100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424736000000",
    "number": "1114344983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 EASTERN BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361161700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 NEW ORLEANS RD",
            "address_2": "SUITE 100",
            "city": "HILTON HEAD",
            "state": "SC",
            "postal_code": "299284721",
            "telephone_number": "334-819-4500",
            "fax_number": "334-819-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTELLIGENETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-18",
        "last_updated": "2015-02-24",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JANUARY",
        "authorized_official_middle_name": "MILLER",
        "authorized_official_title_or_position": "VP, HR",
        "authorized_official_telephone_number": "334-819-4500"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "SC",
            "license": "8038983432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dennis Richard Ittenbach, PT, MS

• Clinical Medical Laboratory in Hilton Head, SC
• Providers in Hilton Head, SC by specialty
• Clinical Medical Laboratory in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; 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.