NPIMap

Organization Active NPI

NDC of Volusia LLC

  • Neurology Physician
  • New Smyrna Beach, FL
National Provider Identifier
1053759183
Registry record updated Mar 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME73099 Issued in FL
Legal business name
NDC OF VOLUSIA LLC
Practice address
1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201
Phone
(386) 423-0505
Fax
(386) 423-0515
NPI assigned
Jun 11, 2013
Last updated
Mar 13, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2014

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

Authorized official

Name
Dr. Rajesh K Ailani, M.D.NPI 1649277880
Title
Owner
Phone
(386) 423-0505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME73099 FL Primary

Addresses

Primary practice location

1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201

Mailing address

1055 N Dixie Fwy
Suite 1
New Smyrna Beach, FL 32168-6201
Phone (386) 423-0505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130820000256 FL Part B Supplier - Clinic/Group Practice 6305088436 Receives reassigned benefits from 4 practitioners
Practice locations: New Smyrna Beach, FL; Port Orange, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1053759183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N DIXIE FWY",
            "address_2": "SUITE 1",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686201",
            "telephone_number": "386-423-0505",
            "fax_number": "386-423-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N DIXIE FWY",
            "address_2": "SUITE 1",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321686201",
            "telephone_number": "386-423-0505",
            "fax_number": "386-423-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NDC OF VOLUSIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-11",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "AILANI",
        "authorized_official_first_name": "RAJESH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-423-0505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME73099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.