NPIMap

Organization Active NPI

VA Primary Care Clinic

  • Clinic/Center
  • Fort Pierce, FL
National Provider Identifier
1891775581
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
SW7718 Issued in FL
Legal business name
VA PRIMARY CARE CLINIC
Practice address
727 N US Highway 1
Fort Pierce, FL 34950-9125
Phone
(772) 595-5150
Fax
(772) 595-6560
NPI assigned
Jan 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Carole Beth Eilenberg, LCSW
Title
Social Worker
Phone
(772) 595-5150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X SW7718 FL Primary

Addresses

Primary practice location

727 N US Highway 1
Fort Pierce, FL 34950-9125

Mailing address

727 N US Highway 1
Fort Pierce, FL 34950-9125
Phone (772) 595-5150

National Provider Directory

National Provider Directory

Locations

727 N US Highway 1
Fort Pierce, FL 34950
Phone (772) 595-5150

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891775581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 N US HIGHWAY 1",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349509125",
            "telephone_number": "772-595-5150",
            "fax_number": "772-595-6560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 N US HIGHWAY 1",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349509125",
            "telephone_number": "772-595-5150",
            "fax_number": "772-595-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VA PRIMARY CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EILENBERG",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "772-595-5150",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "SW7718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • 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.