Vincent M Ivers

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME65165 Issued in FL

Legal business name

VINCENT M IVERS

Practice address

301 20TH St
Port St Joe, FL 32456-3301

Phone

(850) 227-7070

Fax

(850) 227-1989

NPI assigned

Aug 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Vincent M Ivers, M.D.NPI 1851366702

Title

President

Phone

(850) 227-7070

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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

• Vincent M Ivers

  • General Practice Physician
  • Port St Joe, FL
  • NPI 1851366702

  FL

  Medicare reassignment NPD Authorized official
• Monica Barfield, ARNP

  • Family Nurse Practitioner
  • Port St Joe, FL
  • NPI 1225538390

  FL

  Medicare reassignment NPD
• Douglas Altman, D.C.

  • Orthopedic Chiropractor
  • Naples, FL
  • NPI 1134236946
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560729600000",
    "number": "1619085354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 TRADEWINDS DR",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324566157",
            "telephone_number": "850-478-1312",
            "fax_number": "850-474-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 20TH ST",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324563301",
            "telephone_number": "850-227-7070",
            "fax_number": "850-227-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINCENT M IVERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2019-06-17",
        "status": "A",
        "authorized_official_last_name": "IVERS",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-227-7070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME65165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "26155",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376567900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Art of Draw
• Derek D Tracy, D.C.
• Lisa M Trautman, APRN PMHNP-BC, FNP-C
• Luis C Vazquez-Alvarado, MD
• Marni Liane Vedova
• Kimberly Thomas Wagner, PT
• Regina C Washabaugh, RN
• David James Whitfield, MSPT, DPT
• Sheila E Whitfield
• Carolyn McCullagh Williams, PA-C

• Internal Medicine Physician in Port St Joe, FL
• Providers in Port St Joe, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.