NPIMap

Organization Active NPI

Anchors Away Medical Corp.

  • Internal Medicine Physician
  • Naples, FL
National Provider Identifier
1942599436
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME85812 Issued in FL
Legal business name
ANCHORS AWAY MEDICAL CORP.
Practice address
1495 Pine Ridge Rd.
Suite 4
Naples, FL 34109
Phone
(239) 594-5456
Fax
(239) 592-5456
NPI assigned
Apr 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Authorized official

Name
Dr. Charles J. Kilo, M.D.
Title
Owner
Phone
(239) 594-5456

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME85812 FL Primary

Addresses

Primary practice location

1495 Pine Ridge Rd.
Suite 4
Naples, FL 34109

Mailing address

1495 Pine Ridge Rd.
Suite 4
Naples, FL 34109
Phone (239) 594-5456

Other identifiers 1

IdentifierTypeStateIssuer
251-031-600MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Anchors Away Medical Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1942599436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 PINE RIDGE RD.",
            "address_2": "SUITE 4",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34109",
            "telephone_number": "239-594-5456",
            "fax_number": "239-592-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 PINE RIDGE RD.",
            "address_2": "SUITE 4",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34109",
            "telephone_number": "239-594-5456",
            "fax_number": "239-592-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANCHORS AWAY MEDICAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "KILO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-594-5456",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME85812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "251-031-600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; 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.