Individual provider Active NPI

Ian Lloyd Garriques Jr., M.D.

  • Internal Medicine Physician
  • Spruce Pine, NC
National Provider Identifier
1912032822
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2006-00656 Issued in NC
Practice address
496 Altapass Hwy
Spruce Pine, NC 28777-3011
Phone
(828) 765-0170
Fax
(828) 765-5877
NPI assigned
Feb 22, 2007
Last updated
Apr 1, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0021275 FL
Internal Medicine Physician 207R00000X 2006-00656 NC Primary

Addresses

Primary practice location

496 Altapass Hwy
Spruce Pine, NC 28777-3011

Mailing address

496 Altapass Hwy
Spruce Pine, NC 28777-3011
Phone (828) 765-0170

Other identifiers 2

IdentifierTypeStateIssuer
52928OtherFLBLUE CROSS, BLUE SHIELD
2071062OtherNCMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0021275FLMDInternal Medicine Physician
2006-00656NCMDInternal Medicine Physician
21275FLMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238544000000",
    "number": "1912032822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 ALTAPASS HWY",
            "city": "SPRUCE PINE",
            "state": "NC",
            "postal_code": "287773011",
            "telephone_number": "828-765-0170",
            "fax_number": "828-765-5877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 ALTAPASS HWY",
            "city": "SPRUCE PINE",
            "state": "NC",
            "postal_code": "287773011",
            "telephone_number": "828-765-0170",
            "fax_number": "828-765-5877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRIQUES",
        "first_name": "IAN",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2009-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "0021275",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2006-00656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS, BLUE SHIELD",
            "identifier": "52928",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2071062",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spruce Pine, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.