Igor Duane Middlebrook, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5101023931 Issued in MI

Practice address

2700 Wayne Memorial Dr
Goldsboro, NC 27534-9494

Phone

(919) 580-0008

NPI assigned

Jul 15, 2007

Reactivated

Mar 28, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Emergency Medicine

Education

Michigan State University College of Osteopathic Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vituity - Michigan Em PCGroup PAC ID 8022414010, 51 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vituity - Michigan Em PC

  • Emergency Medicine Physician
  • Lansing, MI
  • NPI 1144892332

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Goldsboro Emergency Medical Specialists, Inc.

  • Emergency Medicine Physician
  • Goldsboro, NC
  • NPI 1164418232

  Multi-Specialty

  Medicare reassignment NPD
• Immediate Care of Goldsboro, PLLC

  • Emergency Care Clinic/Center
  • Goldsboro, NC
  • NPI 1952397028

  Multi-Specialty

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Edward W Sparrow Hospital Association

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1073588711
  Care Compare affiliation
• Edward W Sparrow Hospital Association

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1760710719
  Care Compare affiliation

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

{
    "created_epoch": "1184457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1679772123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 MEDICAL OFFICE PL",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349417",
            "telephone_number": "919-580-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 WAYNE MEMORIAL DR",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275349494",
            "telephone_number": "919-580-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLEBROOK",
        "first_name": "IGOR",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-15",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "deactivation_date": "2018-03-20",
        "reactivation_date": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101023931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle S. Merritt, PHARM.D.
• Sarah Messersmith, MD
• Gregory S Metcalf, MD
• Jobe Coy Metts III, MD
• Graham Scott Meyer, MD FACEP FAAEM
• Clifton Eugene Middleton II
• Richard Gerry Middleton, CRNA
• Mighty Warriors Christian Fellowship
• Miller and Associates Six PLLC
• Allie Lowell Miller, OTD, OTR/L

• Emergency Medicine Physician in Goldsboro, NC
• Providers in Goldsboro, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.