Integra Clinical Services, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTEGRA CLINICAL SERVICES, LLC

Practice address

6030 Daybreak Cir Ste A150-183
Clarksville, MD 21029-1642

Phone

(844) 856-9355

Fax

(844) 856-9355

NPI assigned

Jun 23, 2016

Organization subpart

No

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

Authorized official

Name

Eric Nixon

Title

Owner

Phone

(844) 856-9355

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1376994129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6030 DAYBREAK CIR STE A150-183",
            "city": "CLARKSVILLE",
            "state": "MD",
            "postal_code": "210291642",
            "telephone_number": "844-856-9355",
            "fax_number": "844-856-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6030 DAYBREAK CIR STE A150-183",
            "city": "CLARKSVILLE",
            "state": "MD",
            "postal_code": "210291642",
            "telephone_number": "844-856-9355",
            "fax_number": "844-856-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRA CLINICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-23",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "NIXON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "844-856-9355"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Clarksville, MD
• Providers in Clarksville, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.