Pbism West Boca, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PBISM WEST BOCA, INC.

Practice address

21737 State Road 7
Boca Raton, FL 33428-2822

Phone

(561) 997-5210

Fax

(561) 331-2542

NPI assigned

May 22, 2019

Organization subpart

No

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

Authorized official

Name

Brad Van Pelt

Title

President

Phone

(561) 395-2920

Specialties & licenses 1

Addresses

Other names 1

• Palm Beach Institute of Sports Medicine Doing business as

Locations

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558483200000",
    "number": "1053978353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3848 FAU BLVD STE 105",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316437",
            "telephone_number": "561-395-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21737 STATE ROAD 7",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334282822",
            "telephone_number": "561-997-5210",
            "fax_number": "561-331-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PBISM WEST BOCA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-22",
        "last_updated": "2019-05-22",
        "status": "A",
        "authorized_official_last_name": "VAN PELT",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-395-2920"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palm Beach Institute of Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• PB Derm, PLLC
• PB Doctors Group, LLC
• Pbag, LLC
• Pbi Medical
• Pbism Premier, Inc.
• PCP 1St
• Pdi Pharmacy Services, Inc.
• Peace Healing and Wellness LLC
• Peace of Mind Evaluations and Consulting Services, LLC
• Peaceful Path Counseling, LLC

• Physical Therapist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.