PHOENIX PRIMARY CARE LLC (NPI# 1508489790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508489790 |
| Entity Type | Organization |
| Organization Name | PHOENIX PRIMARY CARE LLC |
| Practice Address |
26b Office Park Dr Palm Coast FL 32137-3808 |
| Mailing Address |
Po Box 354925 Palm Coast FL 32135-4925 |
| Practice Telephone | 3865972861 |
| Practice Fax Number | 8442723971 |
| Mailing Telephone | 3865972861 |
| Mailing Fax Number | 8442723971 |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2020-05-21 |
| Authorized Official Name | MS. SANDRA SHANK (CEO) |
| Authorized Official Telephone | 3865972861 |
| Is Organization Subpart | Y |
| Parent Organization Name | ABUNDANT LIFE MINISTRIES-HOPE HOUSE, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Abundant Life Ministries-Hope House, Inc. | Other Name - Individual/Organization |
| Street Address |
26B OFFICE PARK DR |
| City | PALM COAST |
| State | FL |
| Zip Code | 32137-3808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922617505 | Palm Coast Alf Management LLC | Assisted Living Facility | 3830 Old Kings Road, Palm Coast, FL 32137 | 2020-07-29 |
| 1093324964 | Akilah Collins | Behavior Technician | 515 Palm Coast Pwky Sw, Suite 6, Palm Coast, FL 32137 | 2020-07-27 |
| 1750929477 | Jeanette Ann Stevens | Technician | 1 Lema Place, Palm Coast, FL 32137 | 2019-12-12 |
| 1649816919 | Patrick Meyer | Occupational Therapy Assistant | 9 Pine Cone Drive, Palm Coast, Palm Coast, FL 32137 | 2019-11-21 |
| 1689230385 | Coastal Care Medical Transport | Non-emergency Medical Transport (VAN) | #2b, 1 Hargrove Grde, Palm Coast, FL 32137 | 2019-05-17 |
| 1407357437 | Palm Coast Counseling, LLC | Counselor | 1 Hargrove Grade, Ste B-1, Palm Coast, FL 32137 | 2018-02-25 |
| 1679081459 | Lance J Langston | Behavior Technician | 2 Crosstie Ct, Palm Coast, FL 32137 | 2018-01-16 |
| 1407360712 | Hanna Mercedes Brown | Behavior Technician | 515 Palm Coast Pkwy, Suite 6/7, Palm Coast, FL 32137 | 2017-11-22 |
| 1760994511 | Sophia's Choice Hands That Help, LLC | Custodial Care Facility | 119 Bud Hollow Dr, Palm Coast, FL 32137 | 2017-11-02 |
| 1922543255 | Megan Katherine Dickerson | Physical Therapist | 250 Palm Coast Pkwy Ne Unit 209a, Palm Coast, FL 32137 | 2016-12-22 |
| Find all providers in zip 32137 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417115528 | Circle of Health Family Practice LLC | Clinic/Center | 10 Florida Park Dr N Ste B, Palm Coast, FL 32137-3893 | 2008-05-26 |
| 1770516924 | First Coast Pediatrics,pa | Clinic/Center | 397 Palm Coast Pkwy Sw, Unit302, Palm Coast, FL 32137-4776 | 2006-07-09 |
| 1548819741 | Florida Primary Care and Sports Medicine, Inc. | Clinic/Center | 140 Pinnacles Dr, Palm Coast, FL 32164-2322 | 2019-09-10 |
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| 1720690704 | Celena Vinent Carbonell M.d., P.a. | Clinic/Center | 1001 N Macdill Ave Ste D, Tampa, FL 33607-5152 | 2020-08-20 |
| 1548871866 | 1st Call Primary Care, LLC | Clinic/Center | 955 S Woodland Blvd Ste A1, Deland, FL 32720-7321 | 2020-08-11 |
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| 1104436492 | Caretinuum Health | Clinic/Center | 3208 W Lake Mary Blvd Ste 1710, Lake Mary, FL 32746-3467 | 2020-08-03 |
| Find all providers with the same taxonomy | ||||
| City | PALM COAST |
| Zip Code | 32137 |
Please comment or provide details below to improve the information on PHOENIX PRIMARY CARE 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.