NPIMap

Organization Active NPI

Lil Bo Peep 3D-4D Ultrasound and Boutique

  • Radiology Clinic/Center
  • Pinehurst, NC
National Provider Identifier
1235514209
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
107830 Issued in NC
Legal business name
LIL BO PEEP 3D-4D ULTRASOUND AND BOUTIQUE
Practice address
80 Aviemore CT
Suite D
Pinehurst, NC 28374-9732
Phone
(910) 690-6894
NPI assigned
Jul 20, 2015
Last updated
Jan 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Authorized official

Name
Cathy Frazier Stanley, RDMSNPI 1538544598
Title
Registered Diagnostic Sonographer
Phone
(910) 690-6894

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 107830 NC Primary

Addresses

Primary practice location

80 Aviemore CT
Suite D
Pinehurst, NC 28374-9732

Mailing address

80 Aviemore CT
Suite D
Pinehurst, NC 28374-9732
Phone (910) 690-6894

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160225000374 NC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7719282045 Receives reassigned benefits from 1 practitioner
Practice locations: Southern Pines, NC
O20190429002756 NC Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 7719282045 Practice locations: Southern Pines, NC

National Provider Directory

National Provider Directory

Locations

80 Aviemore Ct
Ste D
Pinehurst, NC 28374
Phone (315) 729-0767

Practitioners & affiliated clinicians

Practitioners 8

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": "1437350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452729600000",
    "number": "1235514209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 AVIEMORE CT",
            "address_2": "SUITE D",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283749732",
            "telephone_number": "910-690-6894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 AVIEMORE CT",
            "address_2": "SUITE D",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283749732",
            "telephone_number": "910-690-6894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIL BO PEEP 3D-4D ULTRASOUND AND BOUTIQUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-20",
        "last_updated": "2016-01-14",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "FRAZIER",
        "authorized_official_title_or_position": "REGISTERED DIAGNOSTIC SONOGRAPHER",
        "authorized_official_telephone_number": "910-690-6894",
        "authorized_official_credential": "RDMS"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NC",
            "license": "107830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; 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.