Organization Active NPI

DRS Iacobelli & Digregorio, P.C.

  • Dermatology Physician
  • Clinton TWP, MI
National Provider Identifier
1831110774
Registry record updated Aug 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DRS IACOBELLI & DIGREGORIO, P.C.
Practice address
16510 19 Mile Rd
Clinton TWP, MI 48038-1106
Phone
(586) 263-7200
Fax
(586) 263-5331
NPI assigned
Jul 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2007

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

Authorized official

Name
Theresa M Knoblock
Title
Office Manager
Phone
(586) 263-7200

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207N00000X Primary
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X
Procedural Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NS0135X

Addresses

Primary practice location

16510 19 Mile Rd
Clinton TWP, MI 48038-1106

Mailing address

16510 19 Mile Rd
Clinton TWP, MI 48038-1106
Phone (586) 263-7200

National Provider Directory

National Provider Directory

Locations

30795 23 Mile Rd
Ste 207
Chesterfield, MI 48047
Phone (586) 263-7200

16520 19 Mile Rd
Clinton Twp, MI 48038
Phone (586) 263-7200

198 S Main St
Mount Clemens, MI 48043
Phone (586) 466-5960

35050 23 Mile Rd
Ste B
New Baltimore, MI 48047
Phone (586) 716-9276

NPI Registry JSON

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186358400000",
    "number": "1831110774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16510 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381106",
            "telephone_number": "586-263-7200",
            "fax_number": "586-263-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16510 19 MILE RD",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480381106",
            "telephone_number": "586-263-7200",
            "fax_number": "586-263-5331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS IACOBELLI & DIGREGORIO, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-08-06",
        "status": "A",
        "authorized_official_last_name": "KNOBLOCK",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "586-263-7200"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; 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.