NPIMap

Organization Active NPI

Liberty Wellness Services

  • Internal Medicine Physician
  • Raleigh, NC
National Provider Identifier
1639606601
Registry record updated Nov 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40971 Issued in NC
Legal business name
LIBERTY WELLNESS SERVICES
Doing business as
Liberty Wellness Services
Practice address
8601 Six Forks Rd Ste 400
Raleigh, NC 27615-2965
Phone
(470) 273-7109
NPI assigned
May 22, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2017

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

Authorized official

Name
Danny Lipton
Title
Owner
Phone
(917) 855-8336

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 40971 NC Primary

Addresses

Primary practice location

8601 Six Forks Rd Ste 400
Raleigh, NC 27615-2965

Mailing address

3941 Holcomb Bridge Rd Ste 100
Norcross, GA 30092-2292
Phone (470) 273-7109

Other names 1

  • LIBERTY WELLNESS SERVICES Doing business as

National Provider Directory

National Provider Directory

Locations

3941 Holcomb Bridge Rd
Ste 100
Peachtree Corners, GA 30092
Phone (678) 221-3333

NPI Registry JSON

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509926400000",
    "number": "1639606601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3941 HOLCOMB BRIDGE RD STE 100",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922292",
            "telephone_number": "470-273-7109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 SIX FORKS RD STE 400",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276152965",
            "telephone_number": "470-273-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY WELLNESS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-22",
        "last_updated": "2017-11-06",
        "status": "A",
        "authorized_official_last_name": "LIPTON",
        "authorized_official_first_name": "DANNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-855-8336"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "40971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIBERTY WELLNESS SERVICES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LIBERTY WELLNESS SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2017; 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.