NPIMap

Organization Active NPI

Indian River Memorial Hospital Inc

  • Obstetrics & Gynecology Physician
  • Vero Beach, FL
National Provider Identifier
1801855069
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
4029 Issued in FL
Legal business name
INDIAN RIVER MEMORIAL HOSPITAL INC
Practice address
787 37TH St
Suite E-170
Vero Beach, FL 32960-7305
Phone
(772) 770-6116
Fax
(772) 564-6120
NPI assigned
Mar 17, 2006
Last updated
Feb 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Authorized official

Name
Jeffrey L Susi
Title
Ceo/President
Phone
(772) 567-4311

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 4029 FL Primary
Advanced Practice Midwife 367A00000X 4029 FL

Addresses

Primary practice location

787 37TH St
Suite E-170
Vero Beach, FL 32960-7305

Mailing address

1000 36TH St
Vero Beach, FL 32960-4862
Phone (772) 567-4311

Other identifiers 1

IdentifierTypeStateIssuer
21923OtherFLBLUE CROSS

Other names 1

  • Partners In Women's Health Other name

National Provider Directory

National Provider Directory
Tax ID family
Indian River Mem Hosp16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1801855069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 36TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604862",
            "telephone_number": "772-567-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "787 37TH ST",
            "address_2": "SUITE E-170",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329607305",
            "telephone_number": "772-770-6116",
            "fax_number": "772-564-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-17",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "SUSI",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "772-567-4311"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "4029",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "4029",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "21923",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Partners In Women's Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; 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.