Epoc Clinic LLC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

EPOC CLINIC LLC

Practice address

609 Virginia Dr
Orlando, FL 32803-1844

Phone

(407) 898-2046

Fax

(407) 898-2218

NPI assigned

Jul 8, 2009

Organization subpart

No

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

Authorized official

Name

Dr. James S Pendergraft III, MD

Title

Manager

Phone

(407) 898-2046

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247011200000",
    "number": "1376772699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 VIRGINIA DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031844",
            "telephone_number": "407-898-2046",
            "fax_number": "407-898-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 VIRGINIA DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031844",
            "telephone_number": "407-898-2046",
            "fax_number": "407-898-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPOC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-08",
        "last_updated": "2009-07-08",
        "status": "A",
        "authorized_official_last_name": "PENDERGRAFT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "407-898-2046",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; 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.