Physicians Medical Associates, LLC

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

License

ME57901 Issued in FL

Legal business name

PHYSICIANS MEDICAL ASSOCIATES, LLC

Practice address

4905 Lantana Rd
Lake Worth, FL 33463-6915

Phone

(954) 587-7771

Fax

(954) 208-5770

NPI assigned

May 27, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Bill Russell

Title

Ceo

Phone

(954) 587-7771

Specialties & licenses 9

Addresses

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316649600000",
    "number": "1073748695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 542318",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334542318",
            "telephone_number": "954-587-7771",
            "fax_number": "954-208-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 LANTANA RD",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334636915",
            "telephone_number": "954-587-7771",
            "fax_number": "954-208-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-27",
        "last_updated": "2011-09-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "BILL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-587-7771",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "FL",
            "license": "ME57901",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Group Psychotherapy Psychologist in Lake Worth, FL
• Providers in Lake Worth, FL by specialty
• Group Psychotherapy Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.