Joseph W Slattery III MD PA

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

ME63360 Issued in FL

Legal business name

JOSEPH W SLATTERY III MD PA

Practice address

630 S Wickham Rd
Suite 101
West Melbourne, FL 32904-1428

Phone

(321) 952-9993

NPI assigned

Oct 21, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Brett Meehan

Title

Office Manager

Phone

(321) 952-9993

Specialties & licenses 2

Addresses

Other names 1

• Injury Care Clinic Doing business as

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CBBBBA

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292544000000",
    "number": "1578873709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 S WICKHAM RD",
            "address_2": "SUITE 101",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329041428",
            "telephone_number": "321-952-9993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 S WICKHAM RD",
            "address_2": "SUITE 101",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329041428",
            "telephone_number": "321-952-9993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH W SLATTERY III MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-21",
        "last_updated": "2010-12-17",
        "status": "A",
        "authorized_official_last_name": "MEEHAN",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "321-952-9993",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME63360",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "FL",
            "license": "ME63360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Injury Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meagan Jimenez
• John Tice Inc.
• Molly Kathryn Johnson, M.A. SLP
• Austin David Jones, DC
• Andreanos Jordanopoulos, OD
• Patricia Karnback
• Farrah Kaviratna, RD, LD
• Alexandria Keister
• Robert Kennedy, MD
• Kent-Tronics Corp

• Pain Medicine Physician in West Melbourne, FL
• Providers in West Melbourne, FL by specialty
• Pain Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2010; 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.