NPIMap

Organization Active NPI

Southeast Perinatal Associates, Inc.

  • Maternal & Fetal Medicine Physician
  • Plantation, FL
National Provider Identifier
1477535508
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
Legal business name
SOUTHEAST PERINATAL ASSOCIATES, INC.
Practice address
220 SW 84TH Ave
Suite 104
Plantation, FL 33324-2754
Phone
(954) 476-6229
Fax
(954) 476-4679
NPI assigned
Nov 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Authorized official

Name
Kathleen Kondas
Title
Officer
Phone
(877) 328-1119

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Maternal & Fetal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VM0101X Primary

Addresses

Primary practice location

220 SW 84TH Ave
Suite 104
Plantation, FL 33324-2754

Mailing address

5565 Centerview Dr Ste 107
Raleigh, NC 27606-3563

Other identifiers 2

IdentifierTypeStateIssuer
255648101MedicaidFL
38634OtherFLBCBS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626134400000",
    "number": "1477535508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 CENTERVIEW DR STE 107",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276063563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 SW 84TH AVE",
            "address_2": "SUITE 104",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242754",
            "telephone_number": "954-476-6229",
            "fax_number": "954-476-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST PERINATAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A",
        "authorized_official_last_name": "KONDAS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "877-328-1119"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255648101",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "38634",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.