Organization Active NPI

Internal Medicine Diagnostics Inc

  • Internal Medicine Physician
  • Cherokee Village, AR
National Provider Identifier
1114913936
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INTERNAL MEDICINE DIAGNOSTICS INC
Practice address
197 Hospital Dr
Suite B
Cherokee Village, AR 72529-7314
Phone
(870) 257-5118
NPI assigned
Sep 27, 2005
Last updated
Aug 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2007

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

Authorized official

Name
Ms. Nirmal K Sidhu, DVM, MSC
Title
Office Manager
Phone
(870) 257-5118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

197 Hospital Dr
Suite B
Cherokee Village, AR 72529-7314

Mailing address

197 Hospital Dr
Suite B
Cherokee Village, AR 72529-7314
Phone (870) 257-5118

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041203000974 AR Part B Supplier - Clinic/Group Practice 5294791984 Receives reassigned benefits from 1 practitioner
Practice locations: Cherokee Village, AR

National Provider Directory

National Provider Directory

Locations

197 Hospital Dr
Ste B
Cherokee Vlg, AR 72529
Phone (870) 257-5118

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": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186444800000",
    "number": "1114913936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 HOSPITAL DR",
            "address_2": "SUITE B",
            "city": "CHEROKEE VILLAGE",
            "state": "AR",
            "postal_code": "725297314",
            "telephone_number": "870-257-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 HOSPITAL DR",
            "address_2": "SUITE B",
            "city": "CHEROKEE VILLAGE",
            "state": "AR",
            "postal_code": "725297314",
            "telephone_number": "870-257-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE DIAGNOSTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2007-08-07",
        "status": "A",
        "authorized_official_last_name": "SIDHU",
        "authorized_official_first_name": "NIRMAL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "870-257-5118",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DVM, MSC"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherokee Village, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2007; 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.