Destinations Direct Primary Care

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

DESTINATIONS DIRECT PRIMARY CARE

Practice address

338 Via Vera Cruz Ste 100
San Marcos, CA 92078-2645

Phone

(304) 741-3523

NPI assigned

Jul 6, 2021

Last updated

Jul 6, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John C Neely, MD

Title

MD/Ceo

Phone

(304) 741-3523

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625529600000",
    "number": "1346811882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 VIA VERA CRUZ STE 100",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 VIA VERA CRUZ STE 100",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920782645",
            "telephone_number": "304-741-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINATIONS DIRECT PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A",
        "authorized_official_last_name": "NEELY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MD/CEO",
        "authorized_official_telephone_number": "304-741-3523",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.