Provider Demographics
NPI:1821331133
Name:PLESSEN MEDICAL GROUP, LLC
Entity Type:Organization
Organization Name:PLESSEN MEDICAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EA TO CEO AND CMO
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:EAST
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:340-201-3157
Mailing Address - Street 1:3004 ORANGE GROVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CHRISTIANSTED
Mailing Address - State:VI
Mailing Address - Zip Code:00820-4288
Mailing Address - Country:US
Mailing Address - Phone:340-715-7720
Mailing Address - Fax:340-713-9002
Practice Address - Street 1:5 ORANGE GROVE
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:VI
Practice Address - Zip Code:00820
Practice Address - Country:US
Practice Address - Phone:340-715-7720
Practice Address - Fax:340-713-9002
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLESSEN MEDICAL GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-04
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic SurgeryGroup - Multi-Specialty
No261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty