Organization Active NPI

JRV Med Group LLC

  • General Practice Physician
  • Sabana Grande, PR
National Provider Identifier
1821591280
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
JRV MED GROUP LLC
Practice address
62 Calle 25 de Julio
Sabana Grande, PR 00637-1704
Phone
(787) 506-0994
NPI assigned
Mar 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Jerimer J Rodriguez, MD
Title
President
Phone
(787) 506-0994

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

62 Calle 25 de Julio
Sabana Grande, PR 00637-1704

Mailing address

62 Calle 25 de Julio
Sabana Grande, PR 00637-1704
Phone (787) 506-0994

Other practice location 1

47 Calle 4
Bo Belgica
Guanica, PR 00653
Phone (787) 821-7500

Other practice location 2

74 Calle Comercio
Yauco, PR 00698-3542
Phone (787) 267-3056

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200911000258 PR Part B Supplier - Clinic/Group Practice 7719305564 Receives reassigned benefits from 1 practitioner
Practice locations: Guanica, PR; Sabana Grande, PR

National Provider Directory

National Provider Directory

Locations

62 Calle 25 de Julio
Sabana Grande, PR 00637
Phone (787) 506-0994

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1520899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1821591280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 CALLE 25 DE JULIO",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "006371704",
            "telephone_number": "787-506-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 CALLE 25 DE JULIO",
            "city": "SABANA GRANDE",
            "state": "PR",
            "postal_code": "006371704",
            "telephone_number": "787-506-0994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 CALLE 4",
            "address_2": "BO BELGICA",
            "address_purpose": "LOCATION",
            "city": "GUANICA",
            "state": "PR",
            "postal_code": "00653",
            "country_code": "US",
            "telephone_number": "787-821-7500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "74 Calle Comercio",
            "address_purpose": "LOCATION",
            "city": "Yauco",
            "state": "PR",
            "postal_code": "006983542",
            "country_code": "US",
            "telephone_number": "787-267-3056",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JRV MED GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-13",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "JERIMER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "787-506-0994",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sabana Grande, PR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.