Active NPI
Preservation Park Emergency Physicians, LLC
- Emergency Medicine Physician
- Atlantis, FL
National Provider Identifier
1053989228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- PRESERVATION PARK EMERGENCY PHYSICIANS, LLC
- Practice address
- 5301 S Congress Ave
Atlantis, FL 33462-1149 - Phone
- (561) 965-7300
- NPI assigned
- Jun 15, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kathleen Marie Kondas
- Title
- Ao
- Phone
- (973) 251-1132
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary |
Addresses
Primary practice location
5301 S Congress Ave
Atlantis, FL 33462-1149
Mailing address
5565 Centerview Dr Ste 107
Raleigh, NC 27606-3563
Phone (973) 251-1132
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623715200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1623715200000",
"number": "1053989228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5565 CENTERVIEW DR STE 107",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276063563",
"telephone_number": "973-251-1132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5301 S CONGRESS AVE",
"city": "ATLANTIS",
"state": "FL",
"postal_code": "334621149",
"telephone_number": "561-965-7300"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRESERVATION PARK EMERGENCY PHYSICIANS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-06-15",
"last_updated": "2021-06-15",
"certification_date": "2021-06-15",
"status": "A",
"authorized_official_last_name": "KONDAS",
"authorized_official_first_name": "KATHLEEN",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "AO",
"authorized_official_telephone_number": "973-251-1132"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlantis, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.