Irvin Carlyle Bembry, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

22041 Issued in FL

Practice address

413 5TH Ave NW
Jasper, FL 32052-7800

Phone

(386) 792-2985

Fax

(386) 792-0833

NPI assigned

Jun 28, 2005

Last updated

Dec 1, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Irvin C. Bembry, M.D.P.a.

  • Family Medicine Physician
  • Jasper, FL
  • NPI 1306174396
  Authorized official Same address or phone

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259625600000",
    "number": "1649276247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1028",
            "city": "JASPER",
            "state": "FL",
            "postal_code": "320521028",
            "telephone_number": "386-792-2985",
            "fax_number": "386-792-0833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 5TH AVE NW",
            "city": "JASPER",
            "state": "FL",
            "postal_code": "320527800",
            "telephone_number": "386-792-2985",
            "fax_number": "386-792-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEMBRY",
        "first_name": "IRVIN",
        "middle_name": "CARLYLE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2009-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "22041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055712900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Advantage Home Medical Equipment, Inc.
• Robyn Allen
• B a R Medical Corporation
• Owen J Boales, D.M.D.
• Betty Manning Bridges, NURSE PRACTITIONER
• Dorothy Lorraine Buffington
• Cason Hall Burnett, MS CCC-SLP
• Caitlin Christine Charette-Zalewski, MS, CPNP

• Family Medicine Physician in Jasper, FL
• Providers in Jasper, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2009; 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.