Interra East Diagnostics LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

INTERRA EAST DIAGNOSTICS LLC

Practice address

128 Millport Cir Ste 200
Greenville, SC 29607-5573

Phone

(864) 315-2627

NPI assigned

Jan 11, 2022

Organization subpart

No

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

Authorized official

Name

George Khouri, DO

Title

Sole Member

Phone

(803) 917-8378

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1641859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641859200000",
    "number": "1851042915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 MILLPORT CIR STE 200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075573",
            "telephone_number": "864-315-2627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 MILLPORT CIR STE 200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296075573",
            "telephone_number": "864-315-2627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERRA EAST DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-11",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A",
        "authorized_official_last_name": "KHOURI",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "803-917-8378",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Martha Irby
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• Neurology Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Neurology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.