NPIMap

Organization Active NPI

North Carolina Mobile Ultrasound

  • Diagnostic Ultrasound Physician
  • Clemmons, NC
National Provider Identifier
1922131200
Registry record updated Oct 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
Legal business name
NORTH CAROLINA MOBILE ULTRASOUND
Practice address
2554 Lewisville-Clemmons Road
Suite 201, Box 11
Clemmons, NC 27012-8110
Phone
(800) 983-9840
Fax
(336) 245-2017
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2009

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

Authorized official

Name
Mr. Paul Darryl Smith Sr.
Title
Owner
Phone
(800) 983-9840

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Ultrasound PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085U0001X NC Primary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X

Addresses

Primary practice location

2554 Lewisville-Clemmons Road
Suite 201, Box 11
Clemmons, NC 27012-8110

Mailing address

2554 Lewisville-Clemmons Road
Suite 201, Box 11
Clemmons, NC 27012-8110
Phone (800) 983-9840

Other identifiers 1

IdentifierTypeStateIssuer
8105017MedicaidNC

Other names 1

  • NCMU Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254787200000",
    "number": "1922131200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2554 LEWISVILLE-CLEMMONS ROAD",
            "address_2": "SUITE 201, BOX 11",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128110",
            "telephone_number": "800-983-9840",
            "fax_number": "336-245-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2554 LEWISVILLE-CLEMMONS ROAD",
            "address_2": "SUITE 201, BOX 11",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128110",
            "telephone_number": "800-983-9840",
            "fax_number": "336-245-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CAROLINA MOBILE ULTRASOUND",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2009-10-06",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "DARRYL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-983-9840",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NC",
            "license": null,
            "primary": true
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8105017",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NCMU",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Clemmons, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.