NPIMap

Organization Active NPI

Gastroenterology Group of the Palm Beaches, PA

  • Gastroenterology Physician
  • West Palm Beach, FL
National Provider Identifier
1477558203
Registry record updated Nov 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME0043419 Issued in FL
Legal business name
GASTROENTEROLOGY GROUP OF THE PALM BEACHES, PA
Practice address
2001 N Flagler Dr
West Palm Beach, FL 33407-6109
Phone
(561) 659-6543
Fax
(561) 659-3533
NPI assigned
Jun 17, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2009

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

Authorized official

Name
Lisa Bolognini
Title
Administrative Director
Phone
(561) 659-6632

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X ME0043419 FL Primary

Addresses

Primary practice location

2001 N Flagler Dr
West Palm Beach, FL 33407-6109

Mailing address

2001 N Flagler Dr
West Palm Beach, FL 33407-6109
Phone (561) 659-6543

Other identifiers 1

IdentifierTypeStateIssuer
042147200MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259539200000",
    "number": "1477558203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N FLAGLER DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334076109",
            "telephone_number": "561-659-6543",
            "fax_number": "561-659-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N FLAGLER DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334076109",
            "telephone_number": "561-659-6543",
            "fax_number": "561-659-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY GROUP OF THE PALM BEACHES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-17",
        "last_updated": "2009-11-30",
        "status": "A",
        "authorized_official_last_name": "BOLOGNINI",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "561-659-6632"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME0043419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042147200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; 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.