Prime OB/GYN P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

PRIME OB/GYN P.A.

Practice address

1111 S Orange Ave
Fourth Floor
Orlando, FL 32806-1236

Phone

(407) 205-7646

Fax

(407) 264-7774

NPI assigned

Feb 6, 2013

Last updated

Feb 6, 2013By 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

Dr. Matthew R Mervis, M.D.NPI 1669476594

Title

Owner/Partner

Phone

(407) 205-7646

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.

• Matthew R Mervis, M.D.

  • Obstetrics & Gynecology Physician
  • Orlando, FL
  • NPI 1669476594
  Authorized official Same address or phone

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

{
    "created_epoch": "1360108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360108800000",
    "number": "1730428020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "773 TERRA PL",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514583",
            "telephone_number": "407-205-7646",
            "fax_number": "407-264-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S ORANGE AVE",
            "address_2": "FOURTH FLOOR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328061236",
            "telephone_number": "407-205-7646",
            "fax_number": "407-264-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME OB/GYN P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-06",
        "last_updated": "2013-02-06",
        "status": "A",
        "authorized_official_last_name": "MERVIS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "407-205-7646",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Prime Choice Home Health LLC (Home Care for the 21st Century-West Orlando)
• Prime Elite Inc
• Prime Hospitalist Group PA
• Prime Imaging Center LLC (Prime Imaging Center)
• Prime Nursing
• Prime Performance Therapy LLC
• Prime Radiology of Maitland Inc
• Prime Radiology of Pine Hills, Inc
• Prime Synergy LLC (Cure aid Pharmacy)
• Prime Therapeutics Pharmacy LLC

• Specialist in Orlando, FL
• Providers in Orlando, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; 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.