INSTITUTE OF COLORECTAL HEALTH & WELLNESS, LLC NPI 1013157163

Specialist in Stuart, FL

NPI 1013157163 Organization Specialist

About INSTITUTE OF COLORECTAL HEALTH & WELLNESS, LLC

Institute Of Colorectal Health & Wellness, Llc is a provider established in Stuart, Florida specializing in specialist. The NPI number of Institute Of Colorectal Health & Wellness, Llc is 1013157163 and was assigned on March 2009. The practitioner's primary taxonomy code is 174400000X with license number ME 69555 (FL). The provider is registered as an organization and their NPI record was last updated 8 years ago. Institute Of Colorectal Health & Wellness, Llc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Deborah Ann Demarta M.d. (Managing Member)

NPI

1013157163

Provider NameINSTITUTE OF COLORECTAL HEALTH & WELLNESS, LLC
Provider Location Address218 SW ATLANTA AVE SUITE D STUART, FL 34994
Provider Mailing Address218 SW ATLANTA AVE STUART, FL 34994
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date03-03-2009
Last Update Date09-16-2013


Primary Taxonomy

Taxonomy Code174400000X
ClassificationSpecialist
TypeOther Service Providers
License No.ME 69555
License StateFL
Taxonomy DescriptionAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Business Address

INSTITUTE OF COLORECTAL HEALTH & WELLNESS, LLC
218 SW ATLANTA AVE
SUITE D
STUART, FL
ZIP 34994
Phone: (772) 539-9556

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Mailing Address

INSTITUTE OF COLORECTAL HEALTH & WELLNESS, LLC
218 SW ATLANTA AVE
STUART, FL
ZIP 34994
Phone: (772) 539-9556



Authorized Official

Authorized Official NameDR. DEBORAH ANN DEMARTA M.D.
Authorized Official TitleMANAGING MEMBER
Authorized Official Phone(772) 539-9556

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
G58414MEDICARE UPIN (02)FL
CO743ZMEDICARE PIN (08)FL

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1467612473DR. DEBORAH ANN DEMARTA M.D., F.A.C.S.
Individual
Colon & Rectal Surgery218 SW ATLANTA AVE
STUART, FL 34994
(772) 539-9556

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.