Organization Active NPI

Pob Associates, PL

  • General Practice Dentistry
  • Port St Lucie, FL
National Provider Identifier
1619248697
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1997 Issued in FL
Legal business name
POB ASSOCIATES, PL
Practice address
1657 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5428
Phone
(772) 337-4115
Fax
(772) 337-4116
NPI assigned
Jan 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Authorized official

Name
Thomas Michael Hickey, D.M.D.
Title
Owner
Phone
(772) 359-8962

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DN1997 FL Primary

Addresses

Primary practice location

1657 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5428

Mailing address

1010 SE Kitching Cove LN
Port St Lucie, FL 34952-5902
Phone (772) 359-8962

National Provider Directory

National Provider Directory

Locations

1657 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (772) 337-4115

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1619248697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 SE KITCHING COVE LN",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525902",
            "telephone_number": "772-359-8962",
            "fax_number": "800-408-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1657 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525428",
            "telephone_number": "772-337-4115",
            "fax_number": "772-337-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POB ASSOCIATES, PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-23",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "HICKEY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-359-8962",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN1997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.