City of Port Orange

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

2725 Issued in FL

Legal business name

CITY OF PORT ORANGE

Practice address

1000 City Center Cir
Port Orange, FL 32129-4144

Phone

(386) 756-5410

Fax

(386) 756-5405

NPI assigned

May 3, 2007

Last updated

Aug 22, 2020By 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

Mr. Russell Troy Rafferty, NREMT-P

Title

EMS Manager

Phone

(386) 756-5410

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881806909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CITY CENTER CIR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294144",
            "telephone_number": "386-756-5410",
            "fax_number": "386-756-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CITY CENTER CIR",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321294144",
            "telephone_number": "386-756-5410",
            "fax_number": "386-756-5405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF PORT ORANGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAFFERTY",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "TROY",
        "authorized_official_title_or_position": "EMS MANAGER",
        "authorized_official_telephone_number": "386-756-5410",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NREMT-P"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "FL",
            "license": "2725",
            "primary": true
        }
    ],
    "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 Aug 22, 2020; 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.