The Institute of Lifestyle and Weight Management

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

00987496 Issued in NC

Legal business name

THE INSTITUTE OF LIFESTYLE AND WEIGHT MANAGEMENT

Practice address

3100 Duraleigh Rd
Suite 200
Raleigh, NC 27612-8106

Phone

(919) 791-1112

NPI assigned

Sep 11, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Ezra Brooks Wilkins, M.D.

Title

President and Ceo

Phone

(919) 791-1112

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189468800000",
    "number": "1609061852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 DURALEIGH RD",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276128106",
            "telephone_number": "919-791-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 DURALEIGH RD",
            "address_2": "SUITE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276128106",
            "telephone_number": "919-791-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE INSTITUTE OF LIFESTYLE AND WEIGHT MANAGEMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A",
        "authorized_official_last_name": "WILKINS",
        "authorized_official_first_name": "EZRA",
        "authorized_official_middle_name": "BROOKS",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "919-791-1112",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NC",
            "license": "00987496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.