NPIMap

Organization Active NPI

Treasure Coast Physical Medicine, LLC

  • General Practice Physician
  • Stuart, FL
National Provider Identifier
1205271699
Registry record updated Jun 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OS 5435 Issued in FL
Legal business name
TREASURE COAST PHYSICAL MEDICINE, LLC
Practice address
529 SE Palm Beach Rd
Suite 102
Stuart, FL 34994-2477
Phone
(772) 781-4044
NPI assigned
Apr 30, 2013
Last updated
Jun 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2013

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

Authorized official

Name
Rebekah Leah Campbell, D.C.NPI 1124284260
Title
Owner
Phone
(561) 809-9805

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X OS 5435 FL Primary

Addresses

Primary practice location

529 SE Palm Beach Rd
Suite 102
Stuart, FL 34994-2477

Mailing address

529 SE Palm Beach Rd
Suite 102
Stuart, FL 34994-2477
Phone (772) 781-4044

National Provider Directory

National Provider Directory

Locations

529 SE Palm Beach Rd
Ste 102
Stuart, FL 34994
Phone (772) 781-4044

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371168000000",
    "number": "1205271699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 SE PALM BEACH RD",
            "address_2": "SUITE 102",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942477",
            "telephone_number": "772-781-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 SE PALM BEACH RD",
            "address_2": "SUITE 102",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942477",
            "telephone_number": "772-781-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE COAST PHYSICAL MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-30",
        "last_updated": "2013-06-14",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "REBEKAH",
        "authorized_official_middle_name": "LEAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-809-9805",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS 5435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.