Premier Infectious Disease Consultants LLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

PREMIER INFECTIOUS DISEASE CONSULTANTS LLC

Practice address

303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709

Phone

(636) 333-4500

NPI assigned

Oct 16, 2012

Organization subpart

No

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

Authorized official

Name

Tanuja Nemani, MDNPI 1144403403

Title

Owner

Phone

(636) 333-4500

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 2

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

• Tanuja Nimish Nemani, M.D.,M.P.H

  • Infectious Disease Physician
  • New Smyrna Beach, FL
  • NPI 1144403403
  Medicare reassignment NPD Authorized official
• Latoya D Moody, ARNP

  • Acute Care Nurse Practitioner
  • Daytona Beach, FL
  • NPI 1558404970
  Medicare reassignment NPD

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1134472087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290310",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321290310",
            "telephone_number": "636-333-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142709",
            "telephone_number": "636-333-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER INFECTIOUS DISEASE CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-16",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "NEMANI",
        "authorized_official_first_name": "TANUJA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-333-4500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Infectious Disease Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Infectious Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.