Innovative Gastroenterology, Inc

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

INNOVATIVE GASTROENTEROLOGY, INC

Practice address

6210 Scott St
Suite 216
Punta Gorda, FL 33950-3901

Phone

(941) 378-3871

NPI assigned

Sep 12, 2016

Last updated

Sep 12, 2016By 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

Kosondra Grant

Title

Medical Billing Manager

Phone

(770) 485-1447

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473638400000",
    "number": "1790233401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 SCOTT ST",
            "address_2": "SUITE 216",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503901",
            "telephone_number": "941-378-3871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6210 SCOTT ST",
            "address_2": "SUITE 216",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339503901",
            "telephone_number": "941-378-3871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE GASTROENTEROLOGY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-12",
        "last_updated": "2016-09-12",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "KOSONDRA",
        "authorized_official_title_or_position": "MEDICAL BILLING MANAGER",
        "authorized_official_telephone_number": "770-485-1447"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Punta Gorda, FL
• Providers in Punta Gorda, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.