Rock Star Rep Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ROCK STAR REP INC

Practice address

10065 US Highway 98 W
Ste B 101
Miramar Beach, FL 32550-4924

Phone

(850) 837-8005

Fax

(850) 837-4352

NPI assigned

Mar 10, 2009

Organization subpart

No

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

Authorized official

Name

Perry Monty Reeves

Title

Ceo

Phone

(863) 513-0349

Specialties & licenses 1

Addresses

Other names 1

• SOUTH WALTON MEDICAL Doing business as

Practitioners 1

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

• Terrance Roland Reeves, M.D.

  • Addiction Medicine (Family Medicine) Physician
  • Navarre, FL
  • NPI 1285662635
  NPD (past)

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

{
    "created_epoch": "1236643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239235200000",
    "number": "1871734541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 OAKWAY DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338058584",
            "telephone_number": "863-513-0349",
            "fax_number": "863-248-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10065 US HIGHWAY 98 W",
            "address_2": "STE B 101",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325504924",
            "telephone_number": "850-837-8005",
            "fax_number": "850-837-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK STAR REP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-10",
        "last_updated": "2009-04-09",
        "status": "A",
        "authorized_official_last_name": "REEVES",
        "authorized_official_first_name": "PERRY",
        "authorized_official_middle_name": "MONTY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "863-513-0349"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH WALTON MEDICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lacrisha Roberts
• Thomas G Roberts, PA-C
• Amber Robey
• Jhona Sativa Robinson
• Margie Faye Robinson, LMT
• Ezra Rodgers, PT
• Kaitlyn Roe
• Camille Stacey-Ann Rowe, COTA/L
• Anaiya D Ruano Olivero, APRN
• Emmalynn Rupert Womack

• Clinic/Center in Miramar Beach, FL
• Providers in Miramar Beach, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.