Ips of Jacksonville LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1176 Issued in FL

Legal business name

IPS OF JACKSONVILLE LLC

Practice address

4754 E State Road 64
Bradenton, FL 34208-9058

Phone

(888) 337-3509

Fax

(941) 328-3997

NPI assigned

Dec 10, 2008

Organization subpart

No

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

Authorized official

Name

Carl R Noback, MDNPI 1386620532

Title

Member

Phone

(941) 360-1566

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carl R Noback, MD

  • Anesthesiology Physician
  • Sarasota, FL
  • NPI 1386620532
  NPD (past) Authorized official

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484006400000",
    "number": "1417192022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 864483",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328864483",
            "telephone_number": "888-337-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4754 E STATE ROAD 64",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342089058",
            "telephone_number": "888-337-3509",
            "fax_number": "941-328-3997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IPS OF JACKSONVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-10",
        "last_updated": "2017-01-10",
        "status": "A",
        "authorized_official_last_name": "NOBACK",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "941-360-1566",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Intile, DC
• Intrepid Anesthesia LLC
• Marcel A Ionita, MD, PHD
• Irina Ioshpe, COTA
• Ipm Institute, Inc.
• Georgia Ireland, PA
• Ashley Nicole Irizarry Gonzalez, DMD
• Sergio I Irizarry Toro
• Kelly C Irvin, SLP
• Rebecca Lynne Irving, PA

• Ambulatory Surgical Clinic/Center in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2017; 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.