NPIMap

Organization Active NPI

Indian River Volunteers in Medicine

  • Primary Care Clinic/Center
  • Viera, FL
National Provider Identifier
1467712695
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
INDIAN RIVER VOLUNTEERS IN MEDICINE
Doing business as
Space Coast Volunteers in Medicine
Practice address
2555 Judge Fran Jamieson Way
Viera, FL 32940-5998
Phone
(321) 639-5813
Fax
(321) 637-7512
NPI assigned
May 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Authorized official

Name
Mr. Lee Allen Stoeckert
Title
It Director
Phone
(321) 639-5813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2555 Judge Fran Jamieson Way
Viera, FL 32940-5998

Mailing address

2555 Judge Fran Jamieson Way
Viera, FL 32940-5998
Phone (321) 639-5813

Other names 1

  • Space Coast Volunteers in Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

1460 Baytree Dr NE
Palm Bay, FL 32905
Phone (321) 914-0915

Practitioners & affiliated clinicians

Practitioners 4

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": "1337644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1467712695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 JUDGE FRAN JAMIESON WAY",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329405998",
            "telephone_number": "321-639-5813",
            "fax_number": "321-637-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 JUDGE FRAN JAMIESON WAY",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329405998",
            "telephone_number": "321-639-5813",
            "fax_number": "321-637-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER VOLUNTEERS IN MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-22",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "STOECKERT",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "IT DIRECTOR",
        "authorized_official_telephone_number": "321-639-5813",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Space Coast Volunteers in Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Viera, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; 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.