NPIMap

Organization Active NPI

South Florida Center of Gastroenterology

  • Gastroenterology Physician
  • Wellington, FL
National Provider Identifier
1689742157
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
OS4502 Issued in FL
Legal business name
SOUTH FLORIDA CENTER OF GASTROENTEROLOGY
Practice address
10115 W Forest Hill Blvd
Suite 100
Wellington, FL 33414-3105
Phone
(561) 798-2425
Fax
(561) 798-6356
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Matthew J Smith, DONPI 1952320897
Title
President
Phone
(561) 798-2425

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X OS4502 FL Primary

Addresses

Primary practice location

10115 W Forest Hill Blvd
Suite 100
Wellington, FL 33414-3105

Mailing address

10115 W Forest Hill Blvd
Suite 100
Wellington, FL 33414-3105
Phone (561) 798-2425

National Provider Directory

National Provider Directory
Tax ID family
South Florida Center of Gastroenterology3 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.

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": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689742157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10115 W FOREST HILL BLVD",
            "address_2": "SUITE 100",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143105",
            "telephone_number": "561-798-2425",
            "fax_number": "561-798-6356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10115 W FOREST HILL BLVD",
            "address_2": "SUITE 100",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143105",
            "telephone_number": "561-798-2425",
            "fax_number": "561-798-6356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA CENTER OF GASTROENTEROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-798-2425",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "OS4502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.