Capernaum Medical Center

Primary specialty

Clinical Neurophysiology PhysicianTaxonomy code 2084N0600X

Legal business name

CAPERNAUM MEDICAL CENTER

Practice address

5129 S Lakeland Dr
Unit 1 and 2
Lakeland, FL 33813-2598

Phone

(212) 361-9408

NPI assigned

Aug 29, 2016

Organization subpart

No

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

Authorized official

Name

Eric R Vernier, MD

Title

President

Phone

(212) 361-9408

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1472428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472428800000",
    "number": "1134675317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95448",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338045448",
            "telephone_number": "212-361-9408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5129 S LAKELAND DR",
            "address_2": "UNIT 1 AND 2",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132598",
            "telephone_number": "212-361-9408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPERNAUM MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-29",
        "last_updated": "2016-08-29",
        "status": "A",
        "authorized_official_last_name": "VERNIER",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-361-9408",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Jon Cannon
• Hilda Valbrun Canon, APRN
• John Gerald Galvez Canto, MD
• Theresa Cao, D.O.
• Capernaum Autism Center LLC
• Capernaum Medical Center for Kids PLLC
• Capernaum Medical Center for Kids PLLC
• Capernaum Medical Center for Kids PLLC
• Alison Caracciola, BCBA
• Gabriel De Jesus Carballo Gutierrez

• Clinical Neurophysiology Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Clinical Neurophysiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.