Id Micro PLLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

MD38189 Issued in TN

Legal business name

ID MICRO PLLC

Practice address

130 W Ravine Rd
Kingsport, TN 37660-3837

Phone

(423) 915-1126

NPI assigned

Jun 18, 2006

Last updated

Jan 24, 2012By 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. Anton Maki Jr., MD

Title

Owner

Phone

(423) 915-1126

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Keith G Porter, MD

  • Internal Medicine Physician
  • Kingsport, TN
  • NPI 1821036179
  NPD (past)

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327363200000",
    "number": "1477598076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603837",
            "telephone_number": "423-915-1126",
            "fax_number": "423-915-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W RAVINE RD",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603837",
            "telephone_number": "423-915-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ID MICRO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2012-01-24",
        "status": "A",
        "authorized_official_last_name": "MAKI",
        "authorized_official_first_name": "ANTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "423-915-1126",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TN",
            "license": "MD38189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jena Elise Hutson, MSN, FNP-BC
• Savannah Faith Hutson, PA-C
• Rita Dawn Hutton, BS
• Vickie Hyder, RPH
• Kurt A Ick, MD
• Lilian Imhaze Ikele, PHARMD
• Illuminate Ketamine Center PLLC (Illuminate Wellness Center)
• Independent Physical Therapy
• Independent Physical Therapy (BenchMark)
• Jean Scott Inderfurth, CRNP

• Infectious Disease Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Infectious Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.