NPIMap

Organization Active NPI

Central Palm Beach Physicians & Urgent Care Inc

  • Family Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1104183672
Registry record updated Apr 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME81066 Issued in FL
Legal business name
CENTRAL PALM BEACH PHYSICIANS & URGENT CARE INC
Practice address
12811 Kenwood LN
Suite 118
Fort Myers, FL 33907-5667
Phone
(772) 467-2677
NPI assigned
Apr 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2012

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

Authorized official

Name
Russ Seger, D.C.NPI 1699742155
Title
Owner
Phone
(561) 967-8888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH5626 FL
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X ME81066 FL Primary

Addresses

Primary practice location

12811 Kenwood LN
Suite 118
Fort Myers, FL 33907-5667

Mailing address

4623 Forest Hill Blvd
Suite 101
West Palm Beach, FL 33415
Phone (561) 967-8888

Other names 1

  • MCPB Orthopedics & Neurosurgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Central Palm Beach Physicians Urgent Care Inc18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334880000000",
    "number": "1104183672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4623 FOREST HILL BLVD",
            "address_2": "SUITE 101",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33415",
            "telephone_number": "561-967-8888",
            "fax_number": "561-641-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12811 KENWOOD LN",
            "address_2": "SUITE 118",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075667",
            "telephone_number": "772-467-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL PALM BEACH PHYSICIANS & URGENT CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-20",
        "last_updated": "2012-04-20",
        "status": "A",
        "authorized_official_last_name": "SEGER",
        "authorized_official_first_name": "RUSS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-967-8888",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH5626",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME81066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCPB Orthopedics & Neurosurgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; 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.