NPI 1104604636 is active in the federal NPPES registry (CMS). Source: NPPES NPI Registry (CMS) (record). Data as of 2026-09-30.
What these registry facts mean
The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an organization, so it may cover several clinicians at this location. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. Hours, walk-in policy, X-ray and lab services and the insurance plans accepted vary by center and are not in the registry — call or check the center's website before you go. For chest pain, trouble breathing, stroke signs or severe bleeding, call 911.
Tip: the phone number is the one on the center's NPI record. Chains sometimes list a central office number; if it doesn't reach this location, search the center's name for its local line. After your visit, ask for a copy of your records to share with your regular doctor.