Thomasville Emergency Physicians LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

THOMASVILLE EMERGENCY PHYSICIANS LLC

Practice address

1809 Granada St
Navarre, FL 32566

Phone

(973) 251-1132

NPI assigned

Aug 2, 2021

Organization subpart

No

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

Authorized official

Name

Kathleen Marie Kondas

Title

Officer

Phone

(973) 251-1132

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635724800000",
    "number": "1851065148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 CENTERVIEW DR STE 107",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276063563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 GRANADA ST",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "32566",
            "telephone_number": "973-251-1132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMASVILLE EMERGENCY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "status": "A",
        "authorized_official_last_name": "KONDAS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "973-251-1132"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "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 Nov 1, 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.