Organization Active NPI

The Medical Group of South Florida Inc

  • Specialist
  • Jupiter, FL
National Provider Identifier
1104126952
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
THE MEDICAL GROUP OF SOUTH FLORIDA INC
Practice address
1094 Military TRL
Jupiter, FL 33458-7021
Phone
(561) 622-6111
Fax
(561) 622-1176
NPI assigned
Oct 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Authorized official

Name
Dr. Joshua Smith, DC
Title
Owner
Phone
(561) 622-6111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1094 Military TRL
Jupiter, FL 33458-7021

Mailing address

1094 Military TRL Dept 4101
Jupiter, FL 33458-7021
Phone (561) 622-6111

Other practice location 1

4700 N Congress Ave Ste 103
West Palm Beach, FL 33407-3284
Phone (561) 255-3131

Other identifiers 3

IdentifierTypeStateIssuer
000S2OtherFLBLUE SHIELD OF FLORIDA
99567OtherFLBCBS
002251800MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
The Medical Group of South7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

1094 Military Trl
#4101
Jupiter, FL 33458

NPI Registry JSON

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

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536019200000",
    "number": "1104126952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1094 MILITARY TRL DEPT 4101",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587021",
            "telephone_number": "561-622-6111",
            "fax_number": "561-246-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1094 MILITARY TRL",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587021",
            "telephone_number": "561-622-6111",
            "fax_number": "561-622-1176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 N Congress Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334073284",
            "country_code": "US",
            "telephone_number": "561-255-3131",
            "fax_number": "855-346-3451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE MEDICAL GROUP OF SOUTH FLORIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-27",
        "last_updated": "2018-09-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-622-6111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF FLORIDA",
            "identifier": "000S2",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "99567",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002251800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2018; 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.