NPIMap

Organization Active NPI

Wuesthoff Memorial Hospital Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Rockledge, FL
National Provider Identifier
1164685756
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
4132 Issued in FL
Legal business name
WUESTHOFF MEMORIAL HOSPITAL INC
Practice address
110 Longwood Ave
Mail Stop #24
Rockledge, FL 32955-2828
Phone
(321) 636-2211
NPI assigned
Jul 3, 2008
Last updated
Jul 3, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
WUESTHOFF MEMORIAL HOSPITAL INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Mr. George Fayer
Title
SVP Cfo
Phone
(321) 636-2211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 4132 FL Primary

Addresses

Primary practice location

110 Longwood Ave
Mail Stop #24
Rockledge, FL 32955-2828

Mailing address

110 Longwood Ave
Mail Stop #24
Rockledge, FL 32955-2828
Phone (321) 636-2211

Other identifiers 1

IdentifierTypeStateIssuer
271959200MedicaidFL

National Provider Directory

National Provider Directory
Part of
Wuesthoff Memorial Hospital

Locations

110 Longwood Ave
Stop 24
Rockledge, FL 32955

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1164685756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LONGWOOD AVE",
            "address_2": "MAIL STOP #24",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552828",
            "telephone_number": "321-636-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LONGWOOD AVE",
            "address_2": "MAIL STOP #24",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552828",
            "telephone_number": "321-636-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WUESTHOFF MEMORIAL HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WUESTHOFF  MEMORIAL HOSPITAL INC",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "FAYER",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "SVP CFO",
        "authorized_official_telephone_number": "321-636-2211",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": "4132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271959200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.