Active NPI
Joan Weber Iacobelli, M.D.
- Surgery Physician
- Orange City, FL
National Provider Identifier
1144267121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- ME 108529
- Practice address
- 2864 Wellness Ave Ste 200
Orange City, FL 32763-8335 - Phone
- (386) 775-0333
- Fax
- (386) 775-0427
- NPI assigned
- May 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 16001 | AL | |
| Surgery Physician | 208600000X | ME 108529 | FL | Primary |
Addresses
Primary practice location
2864 Wellness Ave Ste 200
Orange City, FL 32763-8335
Mailing address
2864 Wellness Ave Ste 200
Orange City, FL 32763-8335
Phone (386) 775-0333
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003413400 | Medicaid | FL | |
| 051083966 | Other | AL | BLUE CROSS BLUE SHIELD |
| 000083966 | Medicaid | AL | |
| 14C4Y | Other | FL | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 108529 | FL | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580428800000",
"number": "1144267121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2864 WELLNESS AVE STE 200",
"city": "ORANGE CITY",
"state": "FL",
"postal_code": "327638335",
"telephone_number": "386-775-0333",
"fax_number": "386-775-0427"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2864 WELLNESS AVE STE 200",
"city": "ORANGE CITY",
"state": "FL",
"postal_code": "327638335",
"telephone_number": "386-775-0333",
"fax_number": "386-775-0427"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IACOBELLI",
"first_name": "JOAN",
"middle_name": "WEBER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-31",
"last_updated": "2020-01-31",
"certification_date": "2020-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AL",
"license": "16001",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "ME 108529",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003413400",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "051083966",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000083966",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "14C4Y",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orange City, FL
- Shawn Huffman
- Alicia Dee Hulsizer
- Teresa K Hunt, PTA
- Tyler Daniel Hurt, AP DOM
- Karen Hutton
- Karen Leigh Ianacone, MSN, IBCLC
- Insights Counseling Center, Inc.
- Institute for Foot and Ankle Surgery
- Intergrated Alternative Professionals
- Interventional Pain Rehab and Regenerative Center of Florida (Anti-Aging, Regeneration and Pain Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.