Patient Provider Network LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PATIENT PROVIDER NETWORK LLC

Practice address

1700 N Dixie Hwy Ste 140
Boca Raton, FL 33432-1808

Phone

(727) 415-2308

NPI assigned

Dec 13, 2021

Last updated

Apr 24, 2022By 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

Michael Bagby

Title

Ambr

Phone

(727) 415-2308

Specialties & licenses 15

Addresses

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650758400000",
    "number": "1285393694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5260 78TH AVE N UNIT 1562",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337808062",
            "telephone_number": "727-415-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N DIXIE HWY STE 140",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334321808",
            "telephone_number": "727-415-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATIENT PROVIDER NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2022-04-24",
        "certification_date": "2022-04-24",
        "status": "A",
        "authorized_official_last_name": "BAGBY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "AMBR",
        "authorized_official_telephone_number": "727-415-2308"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QG0250X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Genetics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "170300000X",
            "taxonomy_group": "",
            "desc": "Genetic Counselor, MS",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jay Patruno, RDN, LDN, CPT, CNC

• Multi-Specialty Clinic/Center in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2022; 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.