Nugenesis Medical LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

NUGENESIS MEDICAL LLC

Practice address

2275 Aloma Ave
Winter Park, FL 32792-3303

Phone

(407) 743-2627

NPI assigned

Feb 17, 2022

Organization subpart

No

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

Authorized official

Name

Mrs. Teri Holmbeck, PA-C

Title

Manager

Phone

(407) 743-2627

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1467107441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 ALOMA AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923303",
            "telephone_number": "407-743-2627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 ALOMA AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923303",
            "telephone_number": "407-743-2627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUGENESIS MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-17",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "HOLMBECK",
        "authorized_official_first_name": "TERI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "407-743-2627",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "xx",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2275 Aloma Ave",
            "city": "Winter Park",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327923303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Clinic/Center in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; 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.