Indian River Pediatrics, PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME78173 Issued in FL

Legal business name

INDIAN RIVER PEDIATRICS, PA

Practice address

840 37TH PL Ste 1N
Vero Beach, FL 32960-6502

Phone

(772) 978-9000

Fax

(772) 978-9922

NPI assigned

Oct 7, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Nancy R Smith

Title

Practice Manager

Phone

(772) 978-9000

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1412640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412640000000",
    "number": "1356744155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 37TH PL STE 1N",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606502",
            "telephone_number": "772-978-9000",
            "fax_number": "772-978-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 37TH PL STE 1N",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606502",
            "telephone_number": "772-978-9000",
            "fax_number": "772-978-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER PEDIATRICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-07",
        "last_updated": "2014-10-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "772-978-9000",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME78173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256588900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Indian River Memorial Hospital Inc (Cleveland Clinic Indian River Hospital)
• Indian River Memorial Hospital, Inc. (Cleveland Clinic Indian River Hospital)
• Indian River Memorial Hospital, Inc. (Behavioral Health Center at Indian River Memorial Hospital, Inc.)
• Indian River MRI Inc
• Indian River Neurosurgical Solutions LLC
• Indian River Pharmacy (Indian River Infusion Services)
• Indian River Pharmacy, Inc. (Perkins Indian River Pharmacy)
• Indian River Physicians LLC
• Indian River Podiatry, PA
• Indian River Primary Care

• Pediatrics Physician in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; 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.