Beachway Medical Group LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BEACHWAY MEDICAL GROUP LLC

Practice address

2600 Quantum Blvd
1St Floor
Boynton Beach, FL 33426

Phone

(877) 389-1135

Fax

(561) 364-3496

NPI assigned

Apr 22, 2016

Last updated

Oct 18, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Olivia Holmes

Title

Cfo

Phone

(561) 865-5896

Specialties & licenses 5

Addresses

Locations

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508284800000",
    "number": "1275987521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 QUANTUM BLVD",
            "address_2": "1ST FLOOR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33426",
            "telephone_number": "561-865-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 QUANTUM BLVD",
            "address_2": "1ST FLOOR",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "33426",
            "telephone_number": "877-389-1135",
            "fax_number": "561-364-3496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHWAY MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-22",
        "last_updated": "2017-10-18",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "561-865-5896"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2017; 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.