INTEGRA CLINICAL SERVICES, LLC (NPI# 1376994129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376994129 |
| Entity Type | Organization |
| Organization Name | INTEGRA CLINICAL SERVICES, LLC |
| Practice Address |
9055 Tamar Dr Columbia MD 21045-2756 |
| Practice Telephone | 8448569355 |
| Practice Fax Number | 8448569355 |
| Mailing Telephone | 8448569355 |
| Mailing Fax Number | 8448569355 |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |
| Authorized Official Name | ERIC NIXON (OWNER) |
| Authorized Official Telephone | 8448569355 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
D67215 | MD | Allopathic & Osteopathic Physicians |
| Street Address |
9055 TAMAR DR |
| City | COLUMBIA |
| State | MD |
| Zip Code | 21045-2756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659870335 | Sollange Clement | Dietitian, Registered | 9055 Tamar Dr, Columbia, MD 21045-2756 | 2018-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497374136 | Keenan Eldridge | Behavior Technician | 8950 Md-108, Suite 100, Columbia, MD 21045 | 2020-04-13 |
| 1730724220 | Luci Lee Redman Cassella | Family Medicine | 8900 Columbia 100 Parway Suite G, Columbia, MD 21045 | 2019-11-08 |
| 1417519414 | Howard County Health Department | Clinic/Center | Cradlerock Elementary School-based Wellness Center, 6700 Cradlerock Way, Columbia, MD 21045 | 2019-07-01 |
| 1649754490 | Dana Pirzchalski | Behavioral Analyst | 8815 Columbia Parkwary, 4, Columbia, MD 21045 | 2018-09-18 |
| 1871089177 | Melissa Jo Kennedy | Behavior Technician | 8815 Columbia Parkway, 4, Columbia, MD 21045 | 2018-07-10 |
| 1497246193 | Kjd | Physical Therapist | 8900 Columbia 100 Pkwy Ste C, Columbia, MD 21045 | 2018-05-29 |
| 1174010276 | Roger Lee | Audiologist | 8600 Snowden River Pkwy #309, Columbia, MD 21045 | 2018-04-16 |
| 1811497910 | Dominique Nichole Hale | Behavior Technician | 8115 Columbia 100 Parkway, Suite 4, Columbia, MD 21045 | 2018-02-15 |
| 1982116802 | Bradley D. Stiles | Acupuncturist | 6257 Deep River Cyn, Columbia, MD 21045 | 2017-11-01 |
| 1194234849 | University of Maryland Eye Associates, P.a. | Eyewear Supplier (Equipment, not the service) | 5900 Waterloo Road, Suite 230, Columbia, MD 21045 | 2017-09-26 |
| Find all providers in zip 21045 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245578426 | Mary Joy Drass | Internal Medicine | 5565 Sterrett Pl Fl 5, Columbia, MD 21044-2665 | 2013-01-23 |
| 1346258746 | Carlton Gregory Cauthen | Internal Medicine | 720 Rabon Rd, Columbia, SC 29203-8900 | 2006-08-03 |
| 1881699957 | Jack Legrand Depriest | Internal Medicine | 1 Richland Medical Park Dr Ste 300, Columbia, SC 29203-6831 | 2005-06-16 |
| 1790143766 | Providence Physician Practices LLC | Internal Medicine | 1655 Bernardin Ave, Ste 350, Columbia, SC 29204-2039 | 2016-02-05 |
| 1760724223 | Aaron Charles Miller | Internal Medicine | 1020 Hitt St, Columbia, MO 65212 | 2013-03-22 |
| 1134482490 | Armin Krvavac | Internal Medicine | One Hospital Dr, Columbia, MO 65212-0001 | 2012-06-21 |
| 1306108790 | Zachary Michael Holliday | Internal Medicine | 1020 Hitt St, Columbia, MO 65212 | 2012-06-12 |
| 1790079085 | Justin Henry Atwood | Internal Medicine | 1 Richland Medical Park Dr, Ste 300, Columbia, SC 29203-6834 | 2011-06-03 |
| 1851603617 | Hariharan Regunath | Internal Medicine | 1020 Hitt St, Columbia, MO 65212-0001 | 2010-07-09 |
| 1073833489 | Providence Pulmonary Specialists, LLC | Internal Medicine | 1655 Bernardin Ave, Suite 350, Columbia, SC 29204-2039 | 2010-06-08 |
| Find all providers in COLUMBIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.