Rommelle Von Such, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME0062070 Issued in FL

Practice address

1 Florida Park Dr N
Suite 109-110
Palm Coast, FL 32137-3852

Phone

(386) 445-3619

Fax

(386) 445-6925

NPI assigned

Aug 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Practice

Education

Boston University School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rez Inc

  • Primary Care Clinic/Center
  • St Augustine, FL
  • NPI 1457411373
  NPD (past)

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1124039409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FLORIDA PARK DR N",
            "address_2": "SUITE 109-110",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373852",
            "telephone_number": "386-445-3619",
            "fax_number": "386-445-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FLORIDA PARK DR N",
            "address_2": "SUITE 109-110",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373852",
            "telephone_number": "386-445-3619",
            "fax_number": "386-445-6925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUCH",
        "first_name": "ROMMELLE",
        "middle_name": "VON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME0062070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karol Isaura Stroup, PT
• Michael D Struble, DC
• Ashley Nicole Stuart
• Teresa Glyn Stuehler
• Jeremy Charles Stultz I
• Breelyn Sugden
• Allyson Rae Suit, D.D.S.
• Jonathan M Sullivan, D.P.M.
• Sunshine Family Healthcare, LLC
• Sunshine Family Healthcare, LLC

• General Practice Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.