Integrated Independent Physicians Network, LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

INTEGRATED INDEPENDENT PHYSICIANS NETWORK, LLC

Practice address

1101 N Lake Destiny Rd Ste 300
Maitland, FL 32751-7121

Phone

(407) 475-9213

Fax

(407) 475-9203

NPI assigned

Nov 23, 2020

Organization subpart

No

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

Authorized official

Name

Kathy Monnett

Title

Executive Assista NT

Phone

(407) 475-9213

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1606089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606089600000",
    "number": "1730783556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N LAKE DESTINY RD STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517121",
            "telephone_number": "407-475-9213",
            "fax_number": "407-475-9203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N LAKE DESTINY RD STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517121",
            "telephone_number": "407-475-9213",
            "fax_number": "407-475-9203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED INDEPENDENT PHYSICIANS NETWORK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A",
        "authorized_official_last_name": "MONNETT",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTA NT",
        "authorized_official_telephone_number": "407-475-9213"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@ipnetworkflorida.net",
            "affiliation": "N",
            "address_1": "1101 N Lake Destiny Rd Ste 300",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327517121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 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.