NPIMap

Organization Active NPI

Diamond Family Practice, PLLC

  • Family Medicine Physician
  • Greensboro, NC
National Provider Identifier
1780652693
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
DIAMOND FAMILY PRACTICE, PLLC
Practice address
1309 Lees Chapel Rd
Greensboro, NC 27455-2601
Phone
(336) 286-5505
Fax
(336) 286-5583
NPI assigned
Mar 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Authorized official

Name
Mrs. Kimberly M Boaze, N.P.
Title
Organizing Member/Owner
Phone
(336) 601-0812

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1309 Lees Chapel Rd
Greensboro, NC 27455-2601

Mailing address

1309 Lees Chapel Rd
Greensboro, NC 27455-2601
Phone (336) 286-5505

Other names 1

  • Lake Jeanette Urgent Care, PLLC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1141776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1780652693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 LEES CHAPEL RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552601",
            "telephone_number": "336-286-5505",
            "fax_number": "336-286-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 LEES CHAPEL RD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552601",
            "telephone_number": "336-286-5505",
            "fax_number": "336-286-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND FAMILY PRACTICE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-08",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "BOAZE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ORGANIZING MEMBER/OWNER",
        "authorized_official_telephone_number": "336-601-0812",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "N.P."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Jeanette Urgent Care, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.