Firemed of Southeast, LLC

Primary specialty

Clinical & Laboratory Immunology (Internal Medicine) PhysicianTaxonomy code 207RI0001X

Legal business name

FIREMED OF SOUTHEAST, LLC

Practice address

2479 Trianna Street
Firemed Southeast
North Port, FL 34291

Phone

(941) 899-1430

NPI assigned

Sep 20, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Anthony C Perkins, IMMUNIZATION SPECIAL

Title

President

Phone

(978) 230-9668

Specialties & licenses 5

Addresses

Other names 1

• PriorityOne EMS and Medical Supply Former legal business name

Electronic endpoints 1

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632096000000",
    "number": "1013687177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2479 TRIANNA STREET",
            "address_2": "FIREMED SOUTHEAST",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "34291",
            "telephone_number": "941-899-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2479 TRIANNA STREET",
            "address_2": "FIREMED SOUTHEAST",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "34291",
            "telephone_number": "941-899-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIREMED OF SOUTHEAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-02",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-230-9668",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "IMMUNIZATION SPECIAL"
    },
    "taxonomies": [
        {
            "code": "207RI0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Clinical & Laboratory Immunology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Direct",
            "affiliation": "N",
            "endpointDescription": "IIS",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2479 Trianna Street",
            "address_2": "FireMed Southeast",
            "city": "North Port",
            "state": "FL",
            "country_code": "US",
            "postal_code": "34291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PriorityOne EMS and Medical Supply",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Internal Medicine Physician in North Port, FL
• Providers in North Port, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; 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.