Mymd Personal Family Care, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

MYMD PERSONAL FAMILY CARE, PLLC

Practice address

110 W Wood Hill Dr Unit 108
Nags Head, NC 27959-9394

Phone

(252) 489-9574

Fax

(252) 457-2250

NPI assigned

Jun 24, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Daugherty Halloran, MD

Title

Owner

Phone

(252) 489-9574

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1871119818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5331 CAPTAINS WAY",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279599502",
            "telephone_number": "252-489-9574",
            "fax_number": "252-457-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W WOOD HILL DR UNIT 108",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279599394",
            "telephone_number": "252-489-9574",
            "fax_number": "252-457-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYMD PERSONAL FAMILY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "HALLORAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "DAUGHERTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-489-9574",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Nags Head, NC
• Providers in Nags Head, NC by specialty
• Primary Care Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.