NPIMap

Organization Active NPI

Independent Medical Group, LLC.

  • Health Service Clinic/Center
  • Coconut Creek, FL
National Provider Identifier
1801487053
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
INDEPENDENT MEDICAL GROUP, LLC.
Practice address
3880 Coconut Creek Pkwy Ste 100
Coconut Creek, FL 33066-1643
Phone
(407) 314-7492
Fax
(833) 258-4230
NPI assigned
Jan 31, 2021
Last updated
Nov 16, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
INDEPENDENT MEDICAL GROUP, LLC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Authorized official

Name
Sonia N Torres
Title
Clinical Operations Manager
Phone
(407) 505-6435

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

3880 Coconut Creek Pkwy Ste 100
Coconut Creek, FL 33066-1643

Mailing address

3880 Coconut Creek Pkwy Ste 100
Coconut Creek, FL 33066-1643
Phone (407) 314-7492

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL www.imghealthclinic.com Direct
Other URL www.imghealthclinic.com Other

National Provider Directory

National Provider Directory
Tax ID family
Independent Medical Group LLC13 organizations share this tax ID, including this one
Part of
Independent Medical Group LLC

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1612051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1801487053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 COCONUT CREEK PKWY STE 100",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661643",
            "telephone_number": "407-314-7492",
            "fax_number": "833-258-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 COCONUT CREEK PKWY STE 100",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661643",
            "telephone_number": "407-314-7492",
            "fax_number": "833-258-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT MEDICAL GROUP, LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDEPENDENT MEDICAL GROUP, LLC.",
        "enumeration_date": "2021-01-31",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "SONIA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CLINICAL OPERATIONS MANAGER",
        "authorized_official_telephone_number": "407-505-6435"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.imghealthclinic.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "27 NE 1st Avenue",
            "city": "Pompano Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.imghealthclinic.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "www.imghealthclinic.com",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "www.imghealthclinic.com",
            "address_1": "3880 Coconut Creek Pkwy Ste 100",
            "city": "Coconut Creek",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330661643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.