Innovamed Internal Medicine Specialists SC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INNOVAMED INTERNAL MEDICINE SPECIALISTS SC

Practice address

2601 N Main St
Rockford, IL 61103-3110

Phone

(815) 987-1802

Fax

(815) 987-1806

NPI assigned

Jul 12, 2006

Organization subpart

No

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

Authorized official

Name

Tracy C Brito, M.D.

Title

President

Phone

(815) 987-1802

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Mary Brown, MD

  • Internal Medicine Physician
  • Rockford, IL
  • NPI 1750365862
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699700229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 N MAIN ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033110",
            "telephone_number": "815-987-1802",
            "fax_number": "815-987-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 N MAIN ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033110",
            "telephone_number": "815-987-1802",
            "fax_number": "815-987-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVAMED INTERNAL MEDICINE SPECIALISTS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRITO",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-987-1802",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Incandela, DPM
• Giovanni Incandela, DPM
• Tina Marie Ingram, LSW
• Theodore S. Ingrassia III, M.D.
• Melissa L. Inman, APN
• Innovamed Veins SC
• Institute of Family Care
• Institute of Family Care
• Integrated Health, SC
• Integrated Homecare Services

• Internal Medicine Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Internal Medicine Physician in Illinois

• 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.