Virtual Urodynamics LLC

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

Organization subpart

No

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

Authorized official

Name

Dr. Carrie Lynn Carda

Title

Owner

Phone

(573) 776-7393

Specialties & licenses 3

Addresses

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": []
}

• Martin Vaughn, CRNA
• Vein & Esthetic Centre
• Robin Denise Vickery, LPC
• Frank J Villamayor, PA-C
• Aaron Vincent
• Visionary Radiology, PC
• Shari Leona Vorhees
• Aubrey Nicole Wade
• Ladonna Lacey Waggoner
• Kevin Dale Wagner, MSW

• Medical Specialty Clinic/Center in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Medical Specialty Clinic/Center in Missouri

• 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.