Integrated Medical Therapy Group LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

INTEGRATED MEDICAL THERAPY GROUP LLC

Practice address

3745 11TH Cir Ste 108
Vero Beach, FL 32960-4838

Phone

(772) 567-1552

Fax

(772) 567-5269

NPI assigned

Aug 1, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Kim Krebs, CPEDC

Title

Office Manager/Billing Specialist

Phone

(772) 567-1552

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Treasure Coast Pediatrics Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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

• Kyria G Gaydosh, PA-C

  • Physician Assistant
  • Vero Beach, FL
  • NPI 1790298511
  NPD (past)
• Jessica Barlow Moale, ARNP-BC

  • Family Nurse Practitioner
  • Sebastian, FL
  • NPI 1528738275
  NPD (past)
• Patrick E Ronan, PAC

  • Physician Assistant
  • Port St Lucie, FL
  • NPI 1275520603
  NPD (past)
• Arleene Michelle Sepulveda, M.T., ASCP, M.D.

  • Pediatrics Physician
  • Sebastian, FL
  • NPI 1770813552

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1669488334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3745 11TH CIR STE 108",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604838",
            "telephone_number": "772-567-1552",
            "fax_number": "772-567-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3745 11TH CIR STE 108",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604838",
            "telephone_number": "772-567-1552",
            "fax_number": "772-567-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL THERAPY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "KREBS",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "OFFICE MANAGER/BILLING SPECIALIST",
        "authorized_official_telephone_number": "772-567-1552",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPEDC"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NPK0N",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Treasure Coast Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pediatrics Physician in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.