Organization Active NPI

Neurology Care Inc

  • Neuromusculoskeletal Medicine & OMM Physician
  • St Augustine, FL
National Provider Identifier
1972791085
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
76693 Issued in FL
Legal business name
NEUROLOGY CARE INC
Practice address
1201 Arapaho Ave
St Augustine, FL 32084-4203
Phone
(904) 829-9919
Fax
(904) 829-2617
NPI assigned
Oct 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Authorized official

Name
Dr. Amudha Perumal, M.D.NPI 1629003579
Title
President
Phone
(904) 829-9919

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 204D00000X 76693 FL Primary

Addresses

Primary practice location

1201 Arapaho Ave
St Augustine, FL 32084-4203

Mailing address

1201 Arapaho Ave
St Augustine, FL 32084-4203
Phone (904) 829-9919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071113000740 FL Part B Supplier - Clinic/Group Practice 8527156215 Receives reassigned benefits from 1 practitioner
Practice locations: St Augustine, FL

National Provider Directory

National Provider Directory

Locations

1201 Arapaho Ave
Ste B
St Augustine, FL 32084

Practitioners & affiliated clinicians

Practitioners 3

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": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1972791085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 ARAPAHO AVE",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320844203",
            "telephone_number": "904-829-9919",
            "fax_number": "904-829-2617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 ARAPAHO AVE",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320844203",
            "telephone_number": "904-829-9919",
            "fax_number": "904-829-2617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "PERUMAL",
        "authorized_official_first_name": "AMUDHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-829-9919",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "FL",
            "license": "76693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.