NPIMap

Organization Active NPI

Peach State Medical Practice, PC

  • Reproductive Endocrinology Physician
  • Miami, FL
National Provider Identifier
1891471280
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
Legal business name
PEACH STATE MEDICAL PRACTICE, PC
Practice address
3141 NE 1St Ave
Miami, FL 33137
Phone
(305) 735-2307
NPI assigned
Jun 22, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Fahimeh Sasan, DO
Title
Founding OBGYN
Phone
(855) 563-2639

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Reproductive Endocrinology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VE0102X Primary

Addresses

Primary practice location

3141 NE 1St Ave
Miami, FL 33137

Mailing address

333 S Desplaines St Ste 201
Chicago, IL 60661-5514
Phone (855) 563-2639

Other names 1

  • Kindbody of FL Medical Practice Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Peach State Medical Practice PC12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1891471280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 S DESPLAINES ST STE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606615514",
            "telephone_number": "855-563-2639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 NE 1ST AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33137",
            "telephone_number": "305-735-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH STATE MEDICAL PRACTICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-22",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A",
        "authorized_official_last_name": "SASAN",
        "authorized_official_first_name": "FAHIMEH",
        "authorized_official_title_or_position": "FOUNDING OBGYN",
        "authorized_official_telephone_number": "855-563-2639",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kindbody of FL Medical Practice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kindbody of FL Medical Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; 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.