Village Medical Injury Care LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

VILLAGE MEDICAL INJURY CARE LLC

Practice address

510 CR 466
Unit 104B
Lady Lake, FL 32159

Phone

(407) 578-9142

NPI assigned

Dec 3, 2018

Organization subpart

No

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

Authorized official

Name

Owen Fraser, MD

Title

President

Phone

(407) 578-9142

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543795200000",
    "number": "1316417462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 CR 466",
            "address_2": "UNIT 104B",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "32159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 CR 466",
            "address_2": "UNIT 104B",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "32159",
            "telephone_number": "407-578-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE MEDICAL INJURY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-03",
        "last_updated": "2018-12-03",
        "status": "A",
        "authorized_official_last_name": "FRASER",
        "authorized_official_first_name": "OWEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-578-9142",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milton C. Vanmeter, DMD
• Rebecca Vann, DNP, APRN, FNP-BC
• Derry Vansicklen, HAS
• Varendra Jamwant DPM
• Marivic Delos Reyes Villa, M.D.
• Village Vein Clinic Inc
• Village Veranda at Lady Lake, LLC (Village Veranda at Lady Lake)
• Village Wellness LLC (Village Wellness)
• Villages Facility Inc (Villages Care Center)
• Villages Mind and Body Institute

• Surgery Physician in Lady Lake, FL
• Providers in Lady Lake, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.