NPIMap

Organization Active NPI

Virtual Urodynamics LLC

  • Medical Specialty Clinic/Center
  • Poplar Bluff, MO
National Provider Identifier
1861782864
Registry record updated Apr 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
MD111753 Issued in MO
Legal business name
VIRTUAL URODYNAMICS LLC
Practice address
2340 Katy LN
Poplar Bluff, MO 63901-2300
Phone
(573) 776-7393
Fax
(573) 776-7396
NPI assigned
Apr 11, 2011
Last updated
Apr 11, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2011

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

Authorized official

Name
Dr. Carrie Lynn CardaNPI 1992777957
Title
Owner
Phone
(573) 776-7393

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X MD111753 MO
Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208800000X MD111753 MO
Medical Specialty Clinic/Center 261QM2500X MD111753 MO Primary

Addresses

Primary practice location

2340 Katy LN
Poplar Bluff, MO 63901-2300

Mailing address

2340 Katy LN
Poplar Bluff, MO 63901-2300
Phone (573) 776-7393

National Provider Directory

National Provider Directory

Locations

2340 Katy Ln
Poplar Bluff, MO 63901
Phone (573) 290-3293

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302480000000",
    "number": "1861782864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2340 KATY LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012300",
            "telephone_number": "573-776-7393",
            "fax_number": "573-776-7396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 KATY LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639012300",
            "telephone_number": "573-776-7393",
            "fax_number": "573-776-7396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRTUAL URODYNAMICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-11",
        "last_updated": "2011-04-11",
        "status": "A",
        "authorized_official_last_name": "CARDA",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-776-7393",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "MD111753",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": "MO",
            "license": "MD111753",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MO",
            "license": "MD111753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

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