Intelligenecg LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

INTELLIGENECG LLC

Practice address

17745 Metcalf Ave BLDG 2
Stilwell, KS 66085-9464

Phone

(913) 258-2301

Fax

(843) 628-3268

NPI assigned

Jun 30, 2016

Last updated

Apr 16, 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

Mr. Mario Oliveira Jr.

Title

Ceo

Phone

(913) 258-2301

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1548611593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17745 METCALF AVE BLDG 2",
            "city": "STILWELL",
            "state": "KS",
            "postal_code": "660859464",
            "telephone_number": "913-258-2301",
            "fax_number": "843-628-3268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17745 METCALF AVE BLDG 2",
            "city": "STILWELL",
            "state": "KS",
            "postal_code": "660859464",
            "telephone_number": "913-258-2301",
            "fax_number": "843-628-3268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTELLIGENECG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-30",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A",
        "authorized_official_last_name": "OLIVEIRA",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "913-258-2301",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Stilwell, KS
• Providers in Stilwell, KS by specialty
• Clinical Medical Laboratory in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.