Active NPI
DMSP LLC
- Podiatric Clinic/Center
- Indian Harbour Beach, FL
National Provider Identifier
1376101923
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatric Clinic/Center
- Legal business name
- DMSP LLC
- Practice address
- 2020 Highway A1A Ste 101
Indian Harbour Beach, FL 32937-3581 - Phone
- (321) 777-4774
- NPI assigned
- May 30, 2019
- Last updated
- May 30, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Eugene Wiggins
- Title
- Credentialing Manager
- Phone
- (904) 955-0562
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatric Clinic/Center | 261QP1100X | NU | Primary |
Addresses
Primary practice location
2020 Highway A1A Ste 101
Indian Harbour Beach, FL 32937-3581
Mailing address
1678 Maeve Cir
Melbourne, FL 32904-7348
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
3000 N Atlantic Ave
Ste 108
Cocoa Beach, FL 32931
Phone (321) 213-1455
2020 Highway A1A
Ste 101
Indian Harbour Beach, FL 32937
Phone (321) 777-4774
2251 Town Center Ave
Ste 101
Melbourne, FL 32940
Phone (772) 779-1137
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Podiatrist
- Indian Harbour Beach, FL
- NPI 1912380791
-
- Anatomic Pathology & Clinical Pathology Physician
- Pompano Beach, FL
- NPI 1447234133
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559174400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1559174400000",
"number": "1376101923",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1678 MAEVE CIR",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329047348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 HIGHWAY A1A STE 101",
"city": "INDIAN HARBOUR BEACH",
"state": "FL",
"postal_code": "329373581",
"telephone_number": "321-777-4774"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DMSP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-05-30",
"last_updated": "2019-05-30",
"status": "A",
"authorized_official_last_name": "WIGGINS",
"authorized_official_first_name": "EUGENE",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "904-955-0562"
},
"taxonomies": [
{
"code": "261QP1100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Podiatric",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indian Harbour Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.