NPIMap

Organization Active NPI

Gi Associates of Brevard

  • Gastroenterology Physician
  • Rockledge, FL
National Provider Identifier
1922274398
Registry record updated Apr 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME49690 Issued in FL
Legal business name
GI ASSOCIATES OF BREVARD
Practice address
1004 Beverly Dr
Suite B
Rockledge, FL 32955-2851
Phone
(321) 637-7655
NPI assigned
May 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2009

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

Authorized official

Name
Sandi Laroche
Title
Mso Credentialing Coordinator
Phone
(321) 449-4168

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X ME49690 FL Primary

Addresses

Primary practice location

1004 Beverly Dr
Suite B
Rockledge, FL 32955-2851

Mailing address

150 N Sykes Creek Pkwy
#300
Merritt Island, FL 32953-3488
Phone (321) 449-4168

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239062400000",
    "number": "1922274398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N SYKES CREEK PKWY",
            "address_2": "#300",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533488",
            "telephone_number": "321-449-4168",
            "fax_number": "321-449-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 BEVERLY DR",
            "address_2": "SUITE B",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552851",
            "telephone_number": "321-637-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GI ASSOCIATES OF BREVARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2009-04-07",
        "status": "A",
        "authorized_official_last_name": "LAROCHE",
        "authorized_official_first_name": "SANDI",
        "authorized_official_title_or_position": "MSO CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "321-449-4168"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME49690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockledge, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2009; 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.