Indian River Rehabilitation Medicine Clinic P a

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

ME79198 Issued in FL

Legal business name

INDIAN RIVER REHABILITATION MEDICINE CLINIC P A

Practice address

631 17TH Street
Vero Beach, FL 32960-5518

Phone

(772) 778-1603

Fax

(772) 231-8470

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

Dr. Iheonu Usouwa Oriaku, M.D.NPI 1164579827

Title

President/ Medical Director

Phone

(772) 643-4208

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Iheonu Usouwa Oriaku, MD

  • Physical Medicine & Rehabilitation Physician
  • Vero Beach, FL
  • NPI 1164579827
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1287619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290384000000",
    "number": "1598065732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 2692",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329612692",
            "telephone_number": "772-778-1603",
            "fax_number": "772-231-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 17TH STREET",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605518",
            "telephone_number": "772-778-1603",
            "fax_number": "772-231-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER REHABILITATION MEDICINE CLINIC P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-21",
        "last_updated": "2010-11-22",
        "status": "A",
        "authorized_official_last_name": "ORIAKU",
        "authorized_official_first_name": "IHEONU",
        "authorized_official_middle_name": "USOUWA",
        "authorized_official_title_or_position": "PRESIDENT/ MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "772-643-4208",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME79198",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME79198",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME79198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259802700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "49280",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Indian River Physicians LLC
• Indian River Podiatry, PA
• Indian River Primary Care
• Indian River Private Duty Nursing
• Indian River Radiology PA
• Indian River Spine & Joint PLLC
• Indian River Surgery Center LTD
• Indian River Surgery Center, LTD.
• Indian River Surgical Associates, LLC
• Indian River Surgical Service Corp.

• Physical Medicine & Rehabilitation Physician in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.