Individual provider Active NPI

Linda Yanik Dula, DO

  • Family Medicine Physician
  • Clyde, NC
National Provider Identifier
1427286566
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2011-00106 Issued in NC
Practice address
360 Hospital Dr
Suite 102
Clyde, NC 28721-0107
Phone
(828) 456-9006
Fax
(828) 456-8199
NPI assigned
Jun 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2011-00106 NC Primary

Addresses

Primary practice location

360 Hospital Dr
Suite 102
Clyde, NC 28721-0107

Mailing address

PO Box 603250
Charlotte, NC 28260-3250
Phone (828) 213-1500

Other identifiers 1

IdentifierTypeStateIssuer
NC0561F135OtherNCMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110727000017 NC Practitioner - Family Practice 4981872587

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2011-00106NCMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1246147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1427286566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 603250",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282603250",
            "telephone_number": "828-213-1500",
            "fax_number": "828-651-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 HOSPITAL DR",
            "address_2": "SUITE 102",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287210107",
            "telephone_number": "828-456-9006",
            "fax_number": "828-456-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULA",
        "first_name": "LINDA",
        "middle_name": "YANIK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-28",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2011-00106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NC0561F135",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clyde, NC

Sources for this page

Verify at the official NPI Registry.