NPIMap

Organization Active NPI

Medical Home Alliance LLC

  • Internal Medicine Physician
  • Lakeland, FL
National Provider Identifier
1508531963
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICAL HOME ALLIANCE LLC
Doing business as
IMA Medical Group - North Lakeland
Practice address
4120 US Highway 98 N Ste 200
Lakeland, FL 33809-3882
Phone
(863) 940-3147
Fax
(863) 940-3141
NPI assigned
Aug 9, 2021
Organization subpart
Yes
Parent organization
MEDICAL HOME ALLIANCE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Authorized official

Name
Vanessa Hourihan
Title
VP of Revenue Cycle
Phone
(407) 845-0322

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

4120 US Highway 98 N Ste 200
Lakeland, FL 33809-3882

Mailing address

6675 Westwood Blvd Ste 475
Orlando, FL 32821-6027
Phone (407) 845-0330

Other names 1

  • IMA Medical Group - North Lakeland Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medical Home Alliance LLC37 organizations share this tax ID, including this one
Part of
Medical Home Alliance LLC

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628467200000",
    "number": "1508531963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6675 WESTWOOD BLVD STE 475",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328216027",
            "telephone_number": "407-845-0330",
            "fax_number": "888-972-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 US HIGHWAY 98 N STE 200",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338093882",
            "telephone_number": "863-940-3147",
            "fax_number": "863-940-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL HOME ALLIANCE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDICAL HOME ALLIANCE LLC",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "HOURIHAN",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE",
        "authorized_official_telephone_number": "407-845-0322"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMA Medical Group - North Lakeland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.