Active NPI
Instaclinic, LLC
- Clinic/Center
- Dallas, TX
National Provider Identifier
1659978401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- Legal business name
- INSTACLINIC, LLC
- Practice address
- 7008 Quartermile LN
Dallas, TX 75248-1448 - Phone
- (307) 256-8556
- NPI assigned
- Oct 5, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amy R Surdam, FNP
- Title
- Coo
- Phone
- (307) 421-7277
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Primary |
Addresses
Primary practice location
7008 Quartermile LN
Dallas, TX 75248-1448
Mailing address
PO Box 1142
Cheyenne, WY 82003-1142
Phone (307) 421-7277
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659978401 | Other | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY, TX, CO
Enrollment records 3
National Provider Directory
National Provider Directory- Tax ID family
- Instaclinic
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinic/Center
- Cheyenne, WY
- NPI 1487366332
Locations
508 W 27th St
Cheyenne, WY 82001
Phone (855) 992-9299
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601856000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1671580800000",
"number": "1659978401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1142",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820031142",
"telephone_number": "307-421-7277"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7008 QUARTERMILE LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752481448",
"telephone_number": "307-256-8556"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INSTACLINIC, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-10-05",
"last_updated": "2022-12-21",
"certification_date": "2022-12-21",
"status": "A",
"authorized_official_last_name": "SURDAM",
"authorized_official_first_name": "AMY",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "307-421-7277",
"authorized_official_credential": "FNP"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1659978401",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.