Individual provider Active NPI

Mike Romain

  • Student in an Organized Health Care Education/Training Program
  • Deerfield Beach, FL
National Provider Identifier
1407157886
Registry record updated Jul 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
201 E Sample Rd
Deerfield Beach, FL 33064-3502
Phone
(954) 394-5840
NPI assigned
Nov 16, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3887 TN
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

201 E Sample Rd
Deerfield Beach, FL 33064-3502

Mailing address

201 E Sample Rd
Deerfield Beach, FL 33064-3502
Phone (954) 394-5840

Other practice location 1

2788 Murfreesboro Pike
Antioch, TN 37013-2004
Phone (615) 367-2211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Health Ventures, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689465600000",
    "number": "1407157886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E SAMPLE RD",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330643502",
            "telephone_number": "954-394-5840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E SAMPLE RD",
            "city": "DEERFIELD BEACH",
            "state": "FL",
            "postal_code": "330643502",
            "telephone_number": "954-394-5840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2788 Murfreesboro Pike",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "TN",
            "postal_code": "370132004",
            "country_code": "US",
            "telephone_number": "615-367-2211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROMAIN",
        "first_name": "MIKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-16",
        "last_updated": "2023-07-16",
        "certification_date": "2023-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3887",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield Beach, FL

Sources for this page

Verify at the official NPI Registry.