Organization Active NPI

LCB Physicians, PLLC

  • Surgery of the Hand (Surgery) Physician
  • New Smyrna Beach, FL
National Provider Identifier
1275163461
Registry record updated Mar 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery of the Hand (Surgery) PhysicianTaxonomy code 2086S0105X
Legal business name
LCB PHYSICIANS, PLLC
Practice address
410 Palmetto St
New Smyrna Beach, FL 32168-7323
Phone
(386) 267-6224
Fax
(386) 703-2304
NPI assigned
Jan 16, 2020
Last updated
Mar 1, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2020

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

Authorized official

Name
Louis Charles Blaum III, MDNPI 1801846373
Title
Owner
Phone
(813) 313-8013

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
Surgery of the Hand (Surgery) Physician 2086S0105X NU Primary

Addresses

Primary practice location

410 Palmetto St
New Smyrna Beach, FL 32168-7323

Mailing address

1648 Taylor Rd # 606
Port Orange, FL 32128-6753
Phone (813) 313-8013

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200221001780 FL Part B Supplier - Clinic/Group Practice 0042647521 Receives reassigned benefits from 1 practitioner
Practice locations: New Smyrna Beach, FL

National Provider Directory

National Provider Directory

Locations

410 Palmetto St
New Smyrna Beach, FL 32168
Phone (386) 267-6224

1648 Taylor Rd
Port Orange, FL 32128
Phone (386) 767-1000

Practitioners & affiliated clinicians

Practitioners 1

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": "1579132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583020800000",
    "number": "1275163461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 TAYLOR RD # 606",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321286753",
            "telephone_number": "813-313-8013",
            "fax_number": "386-703-2304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 PALMETTO ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687323",
            "telephone_number": "386-267-6224",
            "fax_number": "386-703-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LCB PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-16",
        "last_updated": "2020-03-01",
        "certification_date": "2020-03-01",
        "status": "A",
        "authorized_official_last_name": "BLAUM",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-313-8013",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2020; 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.