LS of Raleigh

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

200100941 Issued in NC

Legal business name

LS OF RALEIGH

Practice address

10208 Cerny St
Suite 210
Raleigh, NC 27617-7884

Phone

(919) 457-0340

Fax

(919) 806-2123

NPI assigned

Feb 16, 2011

Organization subpart

Yes

Parent organization

THE PREVENTION GROUPAs reported in NPPES

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

Authorized official

Name

Kristen Spaduzzi

Title

Director of Center Operations

Phone

(919) 457-0340

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1750688438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10208 CERNY ST",
            "address_2": "SUITE 210",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276177884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10208 CERNY ST",
            "address_2": "SUITE 210",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276177884",
            "telephone_number": "919-457-0340",
            "fax_number": "919-806-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LS OF RALEIGH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE PREVENTION GROUP",
        "enumeration_date": "2011-02-16",
        "last_updated": "2011-02-16",
        "status": "A",
        "authorized_official_last_name": "SPADUZZI",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "DIRECTOR OF  CENTER OPERATIONS",
        "authorized_official_telephone_number": "919-457-0340"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200100941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.