Split Mountain Emergency Physicians LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

SPLIT MOUNTAIN EMERGENCY PHYSICIANS LLC

Practice address

322 SW Pine Island
Rd
Cape Coral, FL 33991

Phone

(941) 629-1181

NPI assigned

Sep 10, 2021

Last updated

Nov 10, 2021By 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

Kathleen Kondas

Title

Officer

Phone

(877) 328-1119

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Douglas J. Smith, M.D.

  • Personal Emergency Response Attendant
  • Scottsdale, AZ
  • NPI 1023060332
  NPD (past)

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

{
    "created_epoch": "1631232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1679242853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 CENTERVIEW DR STE 107",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276063563",
            "telephone_number": "877-328-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 SW PINE ISLAND",
            "address_2": "RD",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "33991",
            "telephone_number": "941-629-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPLIT MOUNTAIN EMERGENCY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-10",
        "last_updated": "2021-11-10",
        "certification_date": "2021-10-22",
        "status": "A",
        "authorized_official_last_name": "KONDAS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "877-328-1119"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; 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.