Organization Active NPI

Verimed Health Group Bell Shoals, LLC

  • Primary Care Clinic/Center
  • Brandon, FL
National Provider Identifier
1750018560
Registry record updated Aug 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
VERIMED HEALTH GROUP BELL SHOALS, LLC
Practice address
1150 Bell Shoals Rd
Brandon, FL 33511-9001
Phone
(813) 681-6064
NPI assigned
Aug 2, 2022
Last updated
Aug 2, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2022

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

Authorized official

Name
Mr. Martin Revello
Title
Ceo
Phone
(813) 991-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

1150 Bell Shoals Rd
Brandon, FL 33511-9001

Mailing address

26838 Tanic Dr
Wesley Chapel, FL 33544-4617
Phone (813) 991-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230316001238 FL Part B Supplier - Clinic/Group Practice 3375917214 Receives reassigned benefits from 5 practitioners
Practice locations: Brandon, FL

National Provider Directory

National Provider Directory

Locations

1150 Bell Shoals Rd
Brandon, FL 33511
Phone (813) 681-6064

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659398400000",
    "number": "1750018560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26838 TANIC DR",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335444617",
            "telephone_number": "813-991-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 BELL SHOALS RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335119001",
            "telephone_number": "813-681-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERIMED HEALTH GROUP BELL SHOALS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-02",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A",
        "authorized_official_last_name": "REVELLO",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-991-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.