THE CLINIC AT WALMART OPERATED BY WUESTHOFF HEALTH SYSTEM, LLC (NPI# 1639404643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639404643 |
| Entity Type | Organization |
| Organization Name | THE CLINIC AT WALMART OPERATED BY WUESTHOFF HEALTH SYSTEM, LLC |
| Other Organization Name | CLINIC AT WALMART |
| Practice Address |
1500 E Merritt Island Cswy Merritt Island FL 32952-2612 |
| Mailing Address |
150 N Sykes Creek Pkwy Suite 300 Merritt Island FL 32953-3488 |
| Practice Telephone | 3214494534 |
| Practice Fax Number | 3214494164 |
| Mailing Telephone | 3214494534 |
| Mailing Fax Number | 3214494164 |
| Enumeration Date | 2009-10-08 |
| Last Update Date | 2009-10-08 |
| Authorized Official Name | DAWN SMITTE (OFFICE ASSISTANT WFP) |
| Authorized Official Telephone | 3214494534 |
| Is Organization Subpart | Y |
| Parent Organization Name | WUESTHOFF FAMILY PHYSICIANS INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| CLINIC AT WALMART | Doing Business As Name - Organization |
| Street Address |
1500 E MERRITT ISLAND CSWY |
| City | MERRITT ISLAND |
| State | FL |
| Zip Code | 32952-2612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417974627 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1500 E Merritt Island Cswy, Merritt Island, FL 32952-2612 | 2006-07-16 |
| 1962982843 | Elle Strote | Pharmacist | 1500 E Merritt Island Cswy, Merritt Island, FL 32952-2612 | 2018-08-20 |
| 1306151402 | Rockledge Hma Convenient Care, LLC | Nurse Practitioner | 1500 E Merritt Island Cswy, Merritt Island, FL 32952-2612 | 2010-08-12 |
| 1760637201 | Kimberlee Ann Cavanaugh | Nurse Practitioner | 1500 E Merritt Island Cswy, Suite 300, Merritt Island, FL 32952-2612 | 2008-11-25 |
| 1922139740 | Sherry Necessary-corrigan | Nurse Practitioner | 1500 E Merritt Island Cswy, Merritt Island, FL 32952-2612 | 2007-03-07 |
| 1740374941 | Wal-mart Stores East, Lp | Technician/Technologist | 1500 E Merritt Island Cswy, Merritt Island, FL 32952-2612 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841761673 | Pushpa Daliya | Physical Medicine & Rehabilitation | 1200 S Courtenay Pkwy, Merritt Island, FL 32952 | 2018-12-05 |
| 1407335458 | Merritt Island Outpatient Surgery Center, LLC | Clinic/Center | 450 E Merritt Island Cswy Ste 400, Merritt Island, FL 32952 | 2018-08-10 |
| 1760903272 | Harold A Utt Jr. | Audiologist | 105 N. Banana River Drive, Merritt Island, FL 32952 | 2017-07-06 |
| 1942720982 | Cadiz Senior Care | Assisted Living Facility | 1970 Farrington Drive, Merritt Island, FL 32952 | 2017-06-21 |
| 1891230884 | Jessica Orcel | Behavioral Analyst | 1680 E. Central Avenue, Merritt Island, FL 32952 | 2016-12-29 |
| 1770039539 | Haley Haskins | Student in an Organized Health Care Education/Training Program | 1655 Yates Dr., Merritt Island, FL 32952 | 2016-08-31 |
| 1891150900 | Kristin Stevenson | Case Management | 262 Island Beach Blvd, Mirritt Island, FL 32952 | 2015-12-17 |
| 1568835080 | Brilliant Smiles Orthodontics | Health Maintenance Organization | 455 Magnolia Avenue, Merritt Island, FL 32952 | 2015-11-05 |
| 1184967184 | Roseann Judith Simone | Assisted Living Facility | 280 Bahama Dr, Angel Guardian, Cocoa Beach, FL 32952 | 2013-03-28 |
| 1942558861 | Daven H Patel | Dentist | 800 E. Merritt Island Causeway, Merritt Island, FL 32952 | 2012-08-27 |
| Find all providers in zip 32952 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043875545 | Nichole E Venzara | Family Medicine | 255 Stewart Dr, Merritt Island, FL 32952-6414 | 2019-05-09 |
| 1881946630 | David Bhola | Family Medicine | 2404 N Courtenay Pkwy Ste D, Merritt Island, FL 32953 | 2012-10-03 |
| 1114286762 | Tania Darlene Ziegler | Family Medicine | 220 N Sykes Creek Pkwy Ste 302, Merritt Island, FL 32953-3490 | 2012-05-15 |
| 1760611867 | Nikolaos Kanellopoulos | Family Medicine | 260 N Tropical Trl Ste 105, Merritt Island, FL 32953-4800 | 2009-07-09 |
| 1285607093 | Gregory A Kirk | Family Medicine | 258 Fortenberry Rd, Merritt Island, FL 32952-3619 | 2006-02-10 |
| 1053384875 | John W Knappman | Family Medicine | 2404 N Courtenay Pkwy, Suite D, Merritt Island, FL 32953-4191 | 2006-02-10 |
| 1427049972 | Miguel A Medina Rodriguez | Family Medicine | 2575 N Courtenay Pkwy, Merritt Island, FL 32953-4126 | 2005-11-03 |
| 1336133156 | Rajee Paul | Family Medicine | 1045 N Courtenay Pkwy, Merritt Island, FL 32953-4531 | 2005-09-08 |
| 1457351223 | Susan Carole Fair | Family Medicine | 595 N Courtenay Pkwy, Suite 102, Merritt Island, FL 32953-4851 | 2005-07-22 |
| 1043210826 | Prerna Vijayvargiya | Family Medicine | 220 N Sykes Creek Pkwy Ste 301, Merritt Island, FL 32953-3490 | 2005-07-22 |
| Find all providers in MERRITT ISLAND | ||||
| City | MERRITT ISLAND |
| Zip Code | 32952 |
Please comment or provide details below to improve the information on THE CLINIC AT WALMART OPERATED BY WUESTHOFF HEALTH SYSTEM, 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.