Organization Active NPI

McIlroy Professional Corporation

  • Integrative Medicine Physician
  • Oakland, CA
National Provider Identifier
1902680077
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Integrative Medicine PhysicianTaxonomy code 202D00000X
Legal business name
MCILROY PROFESSIONAL CORPORATION
Practice address
2940 Summit St Ste 2D
Oakland, CA 94609-3416
Phone
(833) 423-4276
Fax
(888) 678-2979
NPI assigned
Aug 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Authorized official

Name
Dr. Richard Harry McIlroy III, MD
Title
Ceo
Phone
(925) 633-4828

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X
Health & Wellness CoachGroup: 193200000X MULTI-SPECIALTY GROUP 171400000X
Integrative Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 202D00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

2940 Summit St Ste 2D
Oakland, CA 94609-3416

Mailing address

5421 Azure CT
Discovery Bay, CA 94505-9218
Phone (925) 775-9495

Other names 1

  • Harmoniously Clinical Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692576000000",
    "number": "1902680077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5421 AZURE CT",
            "city": "DISCOVERY BAY",
            "state": "CA",
            "postal_code": "945059218",
            "telephone_number": "925-775-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 SUMMIT ST STE 2D",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093416",
            "telephone_number": "833-423-4276",
            "fax_number": "888-678-2979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCILROY PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A",
        "authorized_official_last_name": "MCILROY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "HARRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "925-633-4828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "202D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Integrative Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harmoniously Clinical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.