Organization Active NPI

Jpmmh Enterprises of Vero Beach, LLC

  • Physician Assistant
  • Vero Beach, FL
National Provider Identifier
1457635773
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9101301 Issued in FL
Legal business name
JPMMH ENTERPRISES OF VERO BEACH, LLC
Practice address
777 37TH St
Suite B-107
Vero Beach, FL 32960-4873
Phone
(772) 226-5026
Fax
(772) 226-7682
NPI assigned
Oct 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Authorized official

Name
Mr. Larry James, P.A.-CNPI 1073599841
Title
Co-Owner
Phone
(772) 226-5026

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X PA9101301 FL Primary

Addresses

Primary practice location

777 37TH St
Suite B-107
Vero Beach, FL 32960-4873

Mailing address

777 37TH St
Suite B-107
Vero Beach, FL 32960-4873
Phone (772) 226-5026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120229000635 FL Part B Supplier - Clinic/Group Practice 5991963415 Receives reassigned benefits from 3 practitioners
Practice locations: Vero Beach, FL

National Provider Directory

National Provider Directory

Locations

777 37th St
Ste C102
Vero Beach, FL 32960
Phone (772) 226-5026

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330473600000",
    "number": "1457635773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 37TH ST",
            "address_2": "SUITE B-107",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604873",
            "telephone_number": "772-226-5026",
            "fax_number": "772-226-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 37TH ST",
            "address_2": "SUITE B-107",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604873",
            "telephone_number": "772-226-5026",
            "fax_number": "772-226-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JPMMH ENTERPRISES OF VERO BEACH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-05",
        "last_updated": "2012-02-29",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "772-226-5026",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.A.-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.

Verify at the official NPI Registry.