Uscg Medical Clinic Elizabeth City

Primary specialty

Other TechnicianTaxonomy code 247200000X

Legal business name

USCG MEDICAL CLINIC ELIZABETH CITY

Practice address

Comdt CG-1122 U S
2100 2ND St SW, Suite 5314
Washington, DC 20593-0001

Phone

(252) 335-6461

Fax

(252) 335-6255

NPI assigned

Sep 28, 2006

Last updated

Jan 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jose Enrique Lefebre Jr., TECHNICIAN

Title

Technician

Phone

(252) 335-6461

Specialties & licenses 1

Addresses

Other names 1

• stephen c. push memorial clinic Former legal business name

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1952492316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COMDT CG-1122 U S",
            "address_2": "2100 2ND ST SW, SUITE 5314",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "205930001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COMDT CG-1122 U S",
            "address_2": "2100 2ND ST SW, SUITE 5314",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "205930001",
            "telephone_number": "252-335-6461",
            "fax_number": "252-335-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USCG MEDICAL CLINIC ELIZABETH CITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "LEFEBRE",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "ENRIQUE",
        "authorized_official_title_or_position": "TECHNICIAN",
        "authorized_official_telephone_number": "252-335-6461",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "TECHNICIAN"
    },
    "taxonomies": [
        {
            "code": "247200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "stephen c. push memorial clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Other Technician in Washington, DC
• Providers in Washington, DC by specialty
• Other Technician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; 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.