NPIMap

Organization Active NPI

Indian River Memorial Hospital Inc

  • Clinical Medical Laboratory
  • Vero Beach, FL
National Provider Identifier
1932362555
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
4029 Issued in FL
Legal business name
INDIAN RIVER MEMORIAL HOSPITAL INC
Practice address
1000 36TH St
Vero Beach, FL 32960-4862
Phone
(772) 567-4311
NPI assigned
Jul 3, 2008
Last updated
Jul 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Jeffrey L Susi
Title
Ceo
Phone
(772) 567-4311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 4029 FL Primary

Addresses

Primary practice location

1000 36TH St
Vero Beach, FL 32960-4862

Mailing address

1000 36TH St
Vero Beach, FL 32960-4862
Phone (772) 567-4311

Other identifiers 1

IdentifierTypeStateIssuer
L9299OtherFLBLUE CROSS LAB

Other names 1

  • Independent Clinical Laboratory Other name

National Provider Directory

National Provider Directory
Tax ID family
Cleveland Clinic Indian River Hospital16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1932362555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 36TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604862",
            "telephone_number": "772-567-4311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 36TH ST",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604862",
            "telephone_number": "772-567-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-03",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "SUSI",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "772-567-4311"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "4029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS LAB",
            "identifier": "L9299",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Independent Clinical Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.