Active NPI
Governor Juan F. Luis Hospital & Medical Center
- Emergency Medicine Physician
- Christiansted, VI
National Provider Identifier
1902588668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- GOVERNOR JUAN F. LUIS HOSPITAL & MEDICAL CENTER
- Practice address
- 4007 Estate Diamond Ruby
Christiansted, VI 00820-4435 - Phone
- (340) 772-7489
- Fax
- (340) 772-7302
- NPI assigned
- Aug 2, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Douglas Edward Koch
- Title
- Chief Executive Officer
- Phone
- (340) 772-7418
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | |||
| Emergency Medicine Physician | 207P00000X | Primary | ||
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | |||
| Cardiovascular Disease Physician | 207RC0000X | |||
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | |||
| Gastroenterology Physician | 207RG0100X | |||
| Nephrology Physician | 207RN0300X | |||
| Obstetrics & Gynecology Physician | 207V00000X | |||
| Orthopaedic Surgery Physician | 207X00000X | |||
| Pediatrics Physician | 208000000X | |||
| Surgery Physician | 208600000X | |||
| Vascular Surgery Physician | 2086S0129X | |||
| Urology Physician | 208800000X | |||
| Hospitalist Physician | 208M00000X |
Addresses
Primary practice location
4007 Estate Diamond Ruby
Christiansted, VI 00820-4435
Mailing address
4007 Estate Diamond Ruby
Christiansted, VI 00820-4435
Phone (340) 778-6311
Other names 1
- St. Croix Hospital
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690934400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1691107200000",
"number": "1902588668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4007 ESTATE DIAMOND RUBY",
"city": "CHRISTIANSTED",
"state": "VI",
"postal_code": "008204435",
"telephone_number": "340-778-6311",
"fax_number": "340-772-7302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4007 ESTATE DIAMOND RUBY",
"city": "CHRISTIANSTED",
"state": "VI",
"postal_code": "008204435",
"telephone_number": "340-772-7489",
"fax_number": "340-772-7302"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOVERNOR JUAN F. LUIS HOSPITAL & MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2023-08-02",
"last_updated": "2023-08-04",
"certification_date": "2023-08-04",
"status": "A",
"authorized_official_last_name": "KOCH",
"authorized_official_first_name": "DOUGLAS",
"authorized_official_middle_name": "EDWARD",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "340-772-7418",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Critical Care Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RN0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "2086S0129X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery, Vascular Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Urology",
"state": null,
"license": null,
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Hospitalist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "St. Croix Hospital",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Christiansted, VI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.