Pbism Premier, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PBISM PREMIER, INC.

Practice address

3848 Fau Blvd Ste 105
Boca Raton, FL 33431-6437

Phone

(561) 395-2920

NPI assigned

Jul 8, 2015

Organization subpart

No

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

Authorized official

Name

Brad Van Pelt

Title

President

Phone

(561) 395-2920

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1215310362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3848 FAU BLVD STE 105",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3848 FAU BLVD STE 105",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316437",
            "telephone_number": "561-395-2920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PBISM PREMIER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "VAN PELT",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-395-2920"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Regina Pazos, PA-C
• PB Derm, PLLC
• PB Doctors Group, LLC
• Pbag, LLC
• Pbi Medical
• Pbism West Boca, Inc.
• PCP 1St
• Pdi Pharmacy Services, Inc.
• Peace Healing and Wellness LLC
• Peace of Mind Evaluations and Consulting Services, LLC

• Physical Therapist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.