NPIMap

Organization Active NPI

Lco Group PA

  • Orthopaedic Surgery Physician
  • Leesburg, FL
National Provider Identifier
1124037783
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME0036469 Issued in FL
Legal business name
LCO GROUP PA
Practice address
600 W North Blvd
Suite C
Leesburg, FL 34748-5063
Phone
(352) 728-3000
Fax
(352) 787-1165
NPI assigned
Aug 5, 2006
Organization subpart
Yes
Parent organization
LCO GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Authorized official

Name
Beverly J Ridley
Title
Account Manager
Phone
(352) 728-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X ME0036469 FL Primary

Addresses

Primary practice location

600 W North Blvd
Suite C
Leesburg, FL 34748-5063

Mailing address

600 W North Blvd
Suite C
Leesburg, FL 34748-5063
Phone (352) 728-3000

Other identifiers 1

IdentifierTypeStateIssuer
251935600MedicaidFL

Other names 1

  • FLORIDA MUSCULOSKELETAL INSTITUTE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040928001063 FL Part B Supplier - Clinic/Group Practice 0749259596 Receives reassigned benefits from 4 practitioners
Practice locations: Leesburg, FL
O20160119000071 FL DME Supplier - Physician - General Practice 0749259596 Practice locations: Leesburg, FL

National Provider Directory

National Provider Directory
Tax ID family
Lco Group PA2 organizations share this tax ID, including this one
Part of
Lco Group PA

Other organizations with this tax ID 1

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

Locations

909 W Magnolia St
Leesburg, FL 34748
Phone (352) 753-4366

600 W North Blvd
Ste C
Leesburg, FL 34748
Phone (352) 728-3000

1400 N US Highway 441
Ste 950
The Villages, FL 32159
Phone (352) 530-2018

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 12

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": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466467200000",
    "number": "1124037783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W NORTH BLVD",
            "address_2": "SUITE C",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485063",
            "telephone_number": "352-728-3000",
            "fax_number": "352-787-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W NORTH BLVD",
            "address_2": "SUITE C",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485063",
            "telephone_number": "352-728-3000",
            "fax_number": "352-787-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LCO GROUP PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LCO GROUP",
        "enumeration_date": "2006-08-05",
        "last_updated": "2016-06-21",
        "status": "A",
        "authorized_official_last_name": "RIDLEY",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "352-728-3000"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME0036469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251935600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FLORIDA MUSCULOSKELETAL INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.