FAMILY PRACTICE AT SOUTHERN TRACE LLC (NPI# 1376759159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1376759159 |
Entity Type | Organization |
Organization Name | FAMILY PRACTICE AT SOUTHERN TRACE LLC |
Practice Address |
3461 Wedgewood Ln The Villages FL 32162-7183 |
Practice Telephone | 3523911400 |
Practice Fax Number | 3523911401 |
Mailing Telephone | 3523911400 |
Mailing Fax Number | 3523911401 |
Enumeration Date | 2007-05-16 |
Last Update Date | 2020-08-22 |
Authorized Official Name | MRS. MICHELLE RIOPELL SPRINGSTEAD (OWNER) |
Authorized Official Telephone | 3523911400 |
Authorized Official Credential | ARNP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
ARNP2965432 | FL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
3461 WEDGEWOOD LN |
City | THE VILLAGES |
State | FL |
Zip Code | 32162-7183 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508936055 | Michelle R. Springstead | Nurse Practitioner | 3461 Wedgewood Ln, The Villages, FL 32162-7183 | 2006-11-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831700939 | Lana Nesheiwat | Pharmacist | 2235 Parr Drive, Lady Lake, FL 32162 | 2020-08-12 |
1619591393 | Advanced Periodontics & Implant Care, LLC | Dentist | 1950 Laurel Manor Drive #184, The Villages, FL 32162 | 2020-05-29 |
1639719081 | Retirement Five, LLC | Skilled Nursing Facility | 16605 Se 74th Souiliere Ave, The Villages, FL 32162 | 2020-01-14 |
1184263261 | Eric William Allen | Pharmacist | Win Dixie Pharmacy #2545, 2500 Burnsed Blvd, The Villages, FL 32162 | 2020-01-06 |
1740828391 | Tara Maria Jennings Irwin | Physical Therapy Assistant | 11962 Cr 101 #104, The Villages, FL 32162 | 2019-12-13 |
1851819254 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 310 Longview Ave, Lady Lake, FL 32162 | 2017-09-06 |
1033642327 | Ben Miller | Specialist/Technologist | 251 Buffalo Trl, The Villages, FL 32162 | 2017-04-04 |
1932631173 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 620 Kristine Way, The Villages, FL 32162 | 2017-03-28 |
1639534522 | Pamela Marie Bureau | Registered Nurse | 1020 Lake Sumter Landing, The Villages, FL 32162 | 2015-12-21 |
1669847059 | Dawn Johnson | Dental Assistant | 8900 Mulberry Ln, The Villages, FL 32162 | 2015-12-10 |
Find all providers in zip 32162 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225411895 | Marsha Marie Houck | Nurse Practitioner | 910 Old Camp Rd Ste 130, The Villages, FL 32162-5609 | 2015-07-01 |
1922359207 | Maria Lisa Byrd | Nurse Practitioner | 1950 Laurel Manor Dr Ste 172, The Villages, FL 32162-5612 | 2012-09-26 |
1508936055 | Michelle R. Springstead | Nurse Practitioner | 3461 Wedgewood Ln, The Villages, FL 32162-7183 | 2006-11-09 |
1659838837 | Nakia Monet Hunter | Nurse Practitioner | 280 Farner Pl, The Villages, FL 32163-6066 | 2019-02-25 |
1770032070 | Sinai Healthcare | Nurse Practitioner | 910 Old Camp Rd, Suite 144, The Villages, FL 32162-5604 | 2016-09-27 |
1801344668 | Arethea Tamara Moise | Nurse Practitioner | 1503 Buenos Aires Blvd, The Villages, FL 32159-6821 | 2016-09-21 |
1275087629 | Jill Marsha Tuke | Nurse Practitioner | 1050 Old Camp Rd Ste 100, The Villages, FL 32162 | 2016-08-14 |
1811347636 | Cary Alan Harbater | Nurse Practitioner | 1580 Santa Barbara Blvd, The Villages, FL 32159-6827 | 2016-06-13 |
1629468400 | Robin Holloway | Nurse Practitioner | 2485 Pinellas Pl, The Villages, FL 32163-2703 | 2015-01-30 |
1316349939 | Brian Reinhartz | Nurse Practitioner | 1451 El Camino Real, The Villages, FL 32159-0041 | 2014-09-26 |
Find all providers in THE VILLAGES |
City | THE VILLAGES |
Zip Code | 32162 |
Please comment or provide details below to improve the information on FAMILY PRACTICE AT SOUTHERN TRACE LLC.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.