NPIMap

Organization Active NPI

Indian River Health Services Inc

Doing business as Irhs-Primary Care South

  • Internal Medicine Physician
  • Vero Beach, FL
National Provider Identifier
1093095333
Registry record updated Aug 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
INDIAN RIVER HEALTH SERVICES INC
Doing business as
Irhs-Primary Care South
Practice address
4165 Oslo Rd
Suite 106
Vero Beach, FL 32968-4878
Phone
(772) 567-4311
Fax
(772) 794-1450
NPI assigned
Aug 18, 2011
Last updated
Aug 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2011

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

Authorized official

Name
Jeffrey L Susi
Title
President/Ceo
Phone
(772) 567-4311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4165 Oslo Rd
Suite 106
Vero Beach, FL 32968-4878

Mailing address

1000 36TH St
Vero Beach, FL 32960-4862
Phone (772) 567-4311

Other names 1

  • IRHS-PRIMARY CARE SOUTH Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070116000060 FL Part B Supplier - Clinic/Group Practice 9234130329 Receives reassigned benefits from 535 practitioners
39 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Vero Beach, FL; West Palm Beach, FL; Weston, FL; Hobe Sound, FL; Palm City, FL; Port Saint Lucie, FL; Sebastian, FL; Stuart, FL

Other NPIs on the same Medicare enrollment 39

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 39

National Provider Directory

National Provider Directory
Tax ID family
Indian River Health Services Inc26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

4165 Oslo Rd
Ste 106
Vero Beach, FL 32968
Phone (772) 569-7706

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313625600000",
    "number": "1093095333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 36TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604862",
            "telephone_number": "772-567-4311",
            "fax_number": "772-794-1450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4165 OSLO RD",
            "address_2": "SUITE 106",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329684878",
            "telephone_number": "772-567-4311",
            "fax_number": "772-794-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-18",
        "last_updated": "2011-08-18",
        "status": "A",
        "authorized_official_last_name": "SUSI",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "772-567-4311"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IRHS-PRIMARY CARE SOUTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.