Northern Medical Center Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

NORTHERN MEDICAL CENTER INC

Practice address

12450 Tamiami TRL S
Suite E
North Port, FL 34287-1473

Phone

(941) 257-4763

Fax

(941) 257-4766

NPI assigned

Jun 6, 2013

Organization subpart

No

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

Authorized official

Name

Daniil Supishchev

Title

Owner

Phone

(941) 257-4763

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Vitaly Y Belevitch, MSPT

  • Physical Therapist
  • Asheboro, NC
  • NPI 1538438163
  NPD (past)

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

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381363200000",
    "number": "1134567613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12450 TAMIAMI TRL S",
            "address_2": "SUITE E",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342871473",
            "telephone_number": "941-257-4763",
            "fax_number": "941-257-4766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12450 TAMIAMI TRL S",
            "address_2": "SUITE E",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342871473",
            "telephone_number": "941-257-4763",
            "fax_number": "941-257-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-06",
        "last_updated": "2013-10-10",
        "status": "A",
        "authorized_official_last_name": "SUPISHCHEV",
        "authorized_official_first_name": "DANIIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-257-4763"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Port Rehab, LLC
• North Port Retirement Center, Inc.
• North Port Smiles LLC
• North Port Womens Care LLC
• Northern Medical and Holistic Center Corp
• Northern Medical Center PC
• Northport Emergency Associates, PA
• Niurka Nunez
• Sherrie O'Callaghan
• Sylvia O'Connor

• General Practice Physician in North Port, FL
• Providers in North Port, 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 Oct 10, 2013; 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.