NPIMap

Organization Active NPI

Desoto Memorial Hospital Inc

  • Rural Acute Care Hospital
  • Arcadia, FL
National Provider Identifier
1982719803
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
License
4218 Issued in FL
Legal business name
DESOTO MEMORIAL HOSPITAL INC
Doing business as
DESOTO MEMORIAL HOSPITAL
Practice address
900 N Roberts Ave
Arcadia, FL 34266-8765
Phone
(863) 494-3535
Fax
(863) 491-4328
NPI assigned
Aug 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Authorized official

Name
Mr. Vincent A Sica
Title
Ceo
Phone
(863) 494-8403

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X 4218 FL Primary

Addresses

Primary practice location

900 N Roberts Ave
Arcadia, FL 34266-8765

Mailing address

900 N Roberts Ave
Arcadia, FL 34266-8765
Phone (863) 494-3535

Other identifiers 3

IdentifierTypeStateIssuer
057132600MedicaidFL
99545OtherFLMEDICARE
010192300MedicaidFL

Other names 1

  • DESOTO MEMORIAL HOSPITAL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Desoto County Hospital District3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278892800000",
    "number": "1982719803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N ROBERTS AVE",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342668765",
            "telephone_number": "863-494-3535",
            "fax_number": "863-491-4328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N ROBERTS AVE",
            "city": "ARCADIA",
            "state": "FL",
            "postal_code": "342668765",
            "telephone_number": "863-494-3535",
            "fax_number": "863-491-4328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESOTO MEMORIAL HOSPITAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2010-07-12",
        "status": "A",
        "authorized_official_last_name": "SICA",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "863-494-8403",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "FL",
            "license": "4218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "057132600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "99545",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010192300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DESOTO MEMORIAL HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arcadia, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.