NPIMap

Organization Active NPI

Neuro Iom Services Inc

  • Neurology Physician
  • Lake Worth, FL
National Provider Identifier
1104980648
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME0044967 Issued in FL
Legal business name
NEURO IOM SERVICES INC
Practice address
1926 10TH Ave N
Suite 105
Lake Worth, FL 33461-3369
Phone
(561) 540-4458
Fax
(561) 540-5939
NPI assigned
Dec 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Authorized official

Name
Mary Johnson
Title
Coo
Phone
(410) 666-2588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X ME0044967 FL Primary

Addresses

Primary practice location

1926 10TH Ave N
Suite 105
Lake Worth, FL 33461-3369

Mailing address

11011 McCormick Rd.
Suite 200
Hunt Valley, MD 21031-8619
Phone (410) 666-2588

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1104980648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 MCCORMICK RD.",
            "address_2": "SUITE 200",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210318619",
            "telephone_number": "410-666-2588",
            "fax_number": "443-403-0207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1926 10TH AVE N",
            "address_2": "SUITE 105",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334613369",
            "telephone_number": "561-540-4458",
            "fax_number": "561-540-5939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURO IOM SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "410-666-2588"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME0044967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.