Surgical Consulting Group PA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME129811 Issued in FL

Legal business name

SURGICAL CONSULTING GROUP PA

Practice address

3050 Champion Ring Rd
Fort Myers, FL 33905-5599

Phone

(941) 621-6577

NPI assigned

Jun 13, 2018

Last updated

Jul 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David T Rideout, MDNPI 1760580054

Title

President

Phone

(207) 240-3362

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• David T Rideout, MD

  • Surgery Physician
  • Fort Myers, FL
  • NPI 1760580054
  Authorized official Same address or phone

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1114410214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 511644",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339511644",
            "telephone_number": "207-240-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 CHAMPION RING RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339055599",
            "telephone_number": "941-621-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL CONSULTING GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-13",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "RIDEOUT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-240-3362",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME129811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102201400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Apinya Suppatkul, PHARM.D.
• Samantha Dawn Surace, FAMILY NURSE PRACTIT
• Surgery Center of Southwest Florida Inc
• Surgery Centre of SW Florida LLC (Fort Myers Surgery Center)
• Surgical Consultants of Southwest Florida, LLC (Gulf Coast Bariatrics)
• Surgical Healing Arts Center, LLC (Surgical Healing Arts)
• Surgical Specialists of Southwest Florida P.a. (Surgical Specialists of Southwest Florida)
• Surgical Spine Associates, LLC (Anesthesia Partners of SWFL)
• Surgicare Center
• Surgicare Center LLC

• Surgery Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.