Indian River Emergency Group, LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

INDIAN RIVER EMERGENCY GROUP, LLC

Practice address

17240 Cortez Blvd
Brooksville, FL 34601-8921

Phone

(352) 796-5111

NPI assigned

Mar 2, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Preston Williams Smith

Title

Chief Revenue Officer

Phone

(770) 874-5400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1881054047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR",
            "address_2": "SUITE 320",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285831",
            "telephone_number": "770-874-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17240 CORTEZ BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346018921",
            "telephone_number": "352-796-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER EMERGENCY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PRESTON",
        "authorized_official_middle_name": "WILLIAMS",
        "authorized_official_title_or_position": "CHIEF REVENUE OFFICER",
        "authorized_official_telephone_number": "770-874-5400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kisha Iglesias, PTA
• Ebenezer I Ikhile, M.D.
• Richard Ilagan, PTA
• Imad E Tarabishy MD PA
• Imperial Mental Health Counseling, LLC
• Brian J Ingleright, D.O.
• Innovative Imaging Associates, PLLC
• Institute of Interventional Pain Management PA
• Integrated Regional Laboratories Pathology Services, LLC
• Janice Chaneco Ipo, PMHNP-BC

• Emergency Medicine Physician in Brooksville, FL
• Providers in Brooksville, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; 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.