Organization Active NPI

Rectal Relief Center

  • Family Nurse Practitioner
  • Loxahatchee, FL
National Provider Identifier
1215190459
Registry record updated Nov 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP3357122 Issued in FL
Legal business name
RECTAL RELIEF CENTER
Practice address
13005 Southern Blvd Ste 122
Suite 122 Medical Mall One
Loxahatchee, FL 33470-9231
Phone
(561) 842-5050
Fax
(561) 793-9989
NPI assigned
Jul 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2011

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

Authorized official

Name
Ms. Sheri Shannon Grisso, ARNPNPI 1801058052
Title
President
Phone
(561) 842-5050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X ARNP3357122 FL Primary

Addresses

Primary practice location

13005 Southern Blvd Ste 122
Suite 122 Medical Mall One
Loxahatchee, FL 33470-9231

Mailing address

13005 Southern Blvd Ste 122
Suite 122 Medical Mall One
Loxahatchee, FL 33470-9231
Phone (561) 842-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090109000604 FL Part B Supplier - Clinic/Group Practice 4789747221 Receives reassigned benefits from 2 practitioners
Practice locations: Loxahatchee, FL; Port St Lucie, FL

National Provider Directory

National Provider Directory

Locations

1701 SE Hillmoor Dr
Unit 14
Port Saint Lucie, FL 34952

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320364800000",
    "number": "1215190459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD STE 122",
            "address_2": "SUITE 122 MEDICAL MALL ONE",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709231",
            "telephone_number": "561-842-5050",
            "fax_number": "561-793-9989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13005 SOUTHERN BLVD STE 122",
            "address_2": "SUITE 122 MEDICAL MALL ONE",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "334709231",
            "telephone_number": "561-842-5050",
            "fax_number": "561-793-9989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RECTAL RELIEF CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2011-11-04",
        "status": "A",
        "authorized_official_last_name": "GRISSO",
        "authorized_official_first_name": "SHERI",
        "authorized_official_middle_name": "SHANNON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-842-5050",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3357122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loxahatchee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.