Spectrum Neurology Group LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

SPECTRUM NEUROLOGY GROUP LLC

Practice address

1800 NW Corporate Blvd Ste 201
Boca Raton, FL 33431-7336

Phone

(877) 414-4480

NPI assigned

Jan 12, 2021

Organization subpart

No

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

Authorized official

Name

Mary Sage

Title

Billing Manager

Phone

(954) 815-2286

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1790374015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 NW CORPORATE BLVD STE 201",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317336",
            "telephone_number": "877-414-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NW CORPORATE BLVD STE 201",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317336",
            "telephone_number": "877-414-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM NEUROLOGY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "SAGE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "954-815-2286"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.