NPIMap

Organization Active NPI

Concentra Primary Care of Illinois PC

  • Primary Care Clinic/Center
  • Addison, TX
National Provider Identifier
1811267396
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CONCENTRA PRIMARY CARE OF ILLINOIS PC
Practice address
5080 Spectrum Dr
Suite 1200 West
Addison, TX 75001-4648
Phone
(972) 364-8000
NPI assigned
Dec 30, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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

Authorized official

Name
Dr. Raad Yaldo, DO
Title
President
Phone
(972) 364-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

5080 Spectrum Dr
Suite 1200 West
Addison, TX 75001-4648

Mailing address

5080 Spectrum Dr
Suite 1200 West
Addison, TX 75001-4648

Other names 1

  • Concentra Primary Care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1325203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434499200000",
    "number": "1811267396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DR",
            "address_2": "SUITE 1200 WEST",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5080 SPECTRUM DR",
            "address_2": "SUITE 1200 WEST",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014648",
            "telephone_number": "972-364-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCENTRA PRIMARY CARE OF ILLINOIS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-30",
        "last_updated": "2015-06-17",
        "status": "A",
        "authorized_official_last_name": "YALDO",
        "authorized_official_first_name": "RAAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-364-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Concentra Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Addison, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; 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.