Ideal Body Institute Hudson ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

IDEAL BODY INSTITUTE HUDSON ASC LLC

Practice address

14012 US Highway 19
Hudson, FL 34667-1165

Phone

(678) 466-6760

Fax

(678) 802-7094

NPI assigned

Apr 19, 2022

Last updated

Apr 19, 2022By 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

Christopher IbikunleNPI 1992981302

Title

MD

Phone

(678) 466-6760

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christopher Alade Ibikunle, M.D.

  • Surgery Physician
  • Loganville, GA
  • NPI 1992981302
  Authorized official Same address or phone

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1821731753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 ATHENS HWY STE 100",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522207",
            "telephone_number": "678-466-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14012 US HIGHWAY 19",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346671165",
            "telephone_number": "678-466-6760",
            "fax_number": "678-802-7094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL BODY INSTITUTE HUDSON ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "IBIKUNLE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "678-466-6760"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Hughes, PA-C
• Michael George Hura, BS PHARMACY
• Syed Hussaini
• Bavly Ibrhim
• Icare360 Imaging LLC
• Nosakhare Idemudia, MD
• Independant Ipa,LLC
• Anthony Wayne Ingram, MS, OTR/L
• Integrated Regional Laboratories Pathology Services, LLC
• Integrity - Hudson Manor, LLC (Hudson Manor , LLC)

• Ambulatory Surgical Clinic/Center in Hudson, FL
• Providers in Hudson, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.