NPIMap

Organization Active NPI

Primary Medical Group Santa Marta

  • Specialist
  • Ponce, PR
National Provider Identifier
1619219425
Registry record updated Apr 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PRIMARY MEDICAL GROUP SANTA MARTA
Practice address
Calle Ferrocarril # 607
Ponce, PR 00717-1195
Phone
(787) 813-0257
Fax
(787) 840-8874
NPI assigned
Mar 19, 2013
Last updated
Apr 4, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2013

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

Authorized official

Name
Dr. Sergio Chevere, M.D.
Title
President
Phone
(787) 813-0257

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

Calle Ferrocarril # 607
Ponce, PR 00717-1195

Mailing address

PO Box 336149
Ponce, PR 00733-6149
Phone (787) 813-0257

Other identifiers 1

IdentifierTypeStateIssuer
0082078OtherPRPROVIDER NUMBER

National Provider Directory

National Provider Directory
Tax ID family
Camg3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365033600000",
    "number": "1619219425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 336149",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007336149",
            "telephone_number": "787-813-0257",
            "fax_number": "787-840-8874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE FERROCARRIL # 607",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007171195",
            "telephone_number": "787-813-0257",
            "fax_number": "787-840-8874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY MEDICAL GROUP SANTA MARTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-04-04",
        "status": "A",
        "authorized_official_last_name": "CHEVERE",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-813-0257",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "0082078",
            "state": "PR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponce, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2013; 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.