Jupiter Primary Care Group Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

JUPITER PRIMARY CARE GROUP INC

Practice address

210 Jupiter Lakes Blvd
Building 4000 Suite 105
Jupiter, FL 33458-7191

Phone

(561) 743-9077

Fax

(561) 745-6529

NPI assigned

May 31, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michelle Fatima Fuller

Title

Office Manager

Phone

(561) 629-2990

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619178001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 JUPITER LAKES BLVD",
            "address_2": "BUILDING 4000 SUITE 105",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587191",
            "telephone_number": "561-743-9077",
            "fax_number": "561-745-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 JUPITER LAKES BLVD",
            "address_2": "BUILDING 4000 SUITE 105",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334587191",
            "telephone_number": "561-743-9077",
            "fax_number": "561-745-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUPITER PRIMARY CARE GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FATIMA FULLER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "561-629-2990"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jupiter Pain Management Consultants
• Jupiter Pathology Consultants PL
• Jupiter Pediatric Associates, PA
• Jupiter Pediatric Dentistry, LLC
• Jupiter Physical Therapy
• Jupiter Primary Care Group Inc
• Jupiter Prosthodontics
• Jupiter Rehab and Health Center, LLC
• Jupiter Senior Living LLC
• Jupiter Senior Living, LLC

• Internal Medicine Physician in Jupiter, FL
• Providers in Jupiter, 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 Aug 22, 2020; 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.