Individual provider Active NPI

Marlon Klaus Sequeira, DVM

  • Veterinarian
  • Raleigh, NC
National Provider Identifier
1306277785
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
7194 Issued in NC
Practice address
11411 Colbert Creek Loop
Raleigh, NC 27614-6670
Phone
(919) 914-0079
NPI assigned
Dec 10, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 7194 NC Primary

Addresses

Primary practice location

11411 Colbert Creek Loop
Raleigh, NC 27614-6670

Mailing address

11411 Colbert Creek Loop Apt 205
Raleigh, NC 27614-6669
Phone (336) 473-0681

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7194NCMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1306277785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11411 COLBERT CREEK LOOP APT 205",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276146669",
            "telephone_number": "336-473-0681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11411 COLBERT CREEK LOOP",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276146670",
            "telephone_number": "919-914-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEQUEIRA",
        "first_name": "MARLON",
        "middle_name": "KLAUS",
        "name_prefix": "Dr.",
        "credential": "DVM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-10",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "NC",
            "license": "7194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; 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.