Shirley a Ice MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0071113 Issued in FL

Legal business name

SHIRLEY A ICE MD PA

Practice address

19204 E Pennsylvania Ave
Dunnellon, FL 34432-6111

Phone

(352) 465-2449

Fax

(352) 465-2451

NPI assigned

Jun 24, 2008

Organization subpart

No

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

Authorized official

Name

Shirley A Ice, MD

Title

President

Phone

(352) 465-2449

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288656000000",
    "number": "1720249410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19204 E PENNSYLVANIA AVE",
            "city": "DUNNELLON",
            "state": "FL",
            "postal_code": "344326111",
            "telephone_number": "352-465-2449",
            "fax_number": "352-465-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19204 E PENNSYLVANIA AVE",
            "city": "DUNNELLON",
            "state": "FL",
            "postal_code": "344326111",
            "telephone_number": "352-465-2449",
            "fax_number": "352-465-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIRLEY A ICE MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2010-11-02",
        "status": "A",
        "authorized_official_last_name": "ICE",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-465-2449",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0071113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2532203400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana L Saunders, M.A., LPC
• Kristine Marie Schmidt
• Nikhil Shah, M.D.
• Destiny Elia Sharp, APRN
• Brian Shenker, O.D.
• Kaie Brady Sibert
• Peter Simon, CST
• Holly Louise Slason
• Adrienne Smith, APRN, FNP-C
• Michael Manning Smith

• Family Medicine Physician in Dunnellon, FL
• Providers in Dunnellon, 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 Nov 2, 2010; 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.