INTERNAL MEDICINE AND PEDIATRICS ASSOCIATESOF TALLAHASSEE INC (NPI# 1982922829) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982922829 |
| Entity Type | Organization |
| Organization Name | INTERNAL MEDICINE AND PEDIATRICS ASSOCIATESOF TALLAHASSEE INC |
| Other Organization Name | IMPACT BEHAVIORAL HEALTH LLC |
| Practice Address |
1965 Capital Cir Ne Suite 102 Tallahassee FL 32308-8401 |
| Mailing Address |
1965 Capital Cir Ne Ste 200 Tallahassee FL 32308-8402 |
| Practice Telephone | 8506714600 |
| Practice Fax Number | 8508782863 |
| Mailing Telephone | 8506562006 |
| Mailing Fax Number | 8506562820 |
| Enumeration Date | 2010-05-16 |
| Last Update Date | 2017-12-01 |
| Authorized Official Name | YVETTE MIGNON (OWNER) |
| Authorized Official Telephone | 8506562006 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | INTERNAL MEDICINE AND PEDIATRICS ASSOCIATESOF TALLAHASSEE INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| N | 101Y00000X | Counselor | 8447 | FL | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
8447 | FL | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | 6702 | FL | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
6702 | FL | Behavioral Health & Social Service Providers |
| Y | 324500000X | Substance Abuse Rehabilitation Facility | FL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MAGELLAN | 600680931 | 01 |
| FL | 003214900 | 05 | |
| FL | LICENSED MENTAL HEALTH COUNSELOR | 8447 | 01 |
| GA | 648299630A | 05 | |
| GA | LICENSED PROFESSIONAL COUNSELOR | 2386 | 01 |
| Other Name | Type Code |
|---|---|
| IMPACT BEHAVIORAL HEALTH LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902469778 | Internal Medicine and Pediatrics Associatesof Tallahassee Inc | Internal Medicine | 1965 Capital Cir Ne Ste 101, Tallahassee, FL 32308-8402 | 2019-04-17 |
| 1629147228 | Internal Medicine and Pediatrics Associatesof Tallahassee Inc | Pediatrics | 1965 Capital Cir Ne, Suite 200, Tallahassee, FL 32308-8401 | 2006-11-07 |
| Street Address |
1965 CAPITAL CIR NE SUITE 102 |
| City | TALLAHASSEE |
| State | FL |
| Zip Code | 32308-8401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649262940 | Pamela Anne Whitworth | Physical Therapist | 1965 Capital Cir Ne, Ste 200, Tallahassee, FL 32308-8402 | 2005-08-22 |
| 1093114720 | Donnett Crumbie | Legal Medicine | 1965 Capital Cir Ne, Tallahassee, FL 32308-8401 | 2014-08-19 |
| 1295148831 | Linda Kahn | Marriage & Family Therapist | 1965 Capital Cir Ne, Suite 102, Tallahassee, FL 32308-8401 | 2014-06-10 |
| 1336575745 | Gladys Jean-francois Benoit | General Practice | 1965 Capital Cir Ne, Tallahassee, FL 32308-8401 | 2013-09-17 |
| 1891064176 | Andreas Ward | Nurse Practitioner | 1965 Capital Cir Ne, Tallahassee, FL 32308-8401 | 2011-12-15 |
| 1245521525 | Pristine Ventures, LLC | Durable Medical Equipment & Medical Supplies | 1965 Capital Cir Ne, Tallahassee, FL 32308-8401 | 2011-04-21 |
| 1861707218 | Celeste Lind | Nurse Practitioner | 1965 Capital Cir Ne, Tallahassee, FL 32308-8401 | 2010-08-10 |
| 1083884241 | Alicia Maki | Psychologist | 1965 Capital Cir Ne, Suite 102, Tallahassee, FL 32308-8401 | 2008-03-04 |
| 1063581650 | Uchenna J Emenike | Legal Medicine | 1965 Capital Cir Ne, Tallahassee, FL 32308-8401 | 2006-11-07 |
| 1629147228 | Internal Medicine and Pediatrics Associatesof Tallahassee Inc | Pediatrics | 1965 Capital Cir Ne, Suite 200, Tallahassee, FL 32308-8401 | 2006-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215588306 | Jmc Tallahassee, LLC | Preventive Medicine | 1838 Jacliff Court, Tallahassee, FL 32308 | 2019-09-20 |
| 1972165108 | Covenant Home Health Care, LLC | Home Health | 1921 Capital Circle Ne, Tallahassee, FL 32308 | 2019-07-09 |
| 1548735798 | North Florida Rehab Solutions | Hospitalist | 1675 Riggins Road, Dr Steele Lancaster, Tallahassee, FL 32308 | 2018-10-03 |
| 1013491596 | Injury and Rehab Centers of North Florida, LLC | Neuromusculoskeletal Medicine & OMM | 2268 Wednesday Street, Tallahassee, Florida, FL 32308 | 2018-09-20 |
| 1487133625 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2634 Capital Circle Ne, Building C, Suite 156, Tallahassee, FL 32308 | 2018-08-08 |
| 1629566724 | Total Health & Wellness Home Care, LLC | Home Health | 1325 Mahan Dr., Tallahassee, FL 32308 | 2018-04-25 |
| 1669979480 | Beth North, Lcsw, LLC | Social Worker | 1325 Mahan Drive, Tallahassee, FL 32308 | 2018-04-09 |
| 1750885919 | Robert E Ashmore Jr Md | Obstetrics & Gynecology | 2770 Capitol Medical Blvd, Suite 100, Tallahassee, FL 32308 | 2018-03-22 |
| 1225547243 | William Michael Kunkle | Physician Assistant | 4004 Norton Ln, Suite 101, Tallahassee, FL 32308 | 2017-09-21 |
| 1235657834 | Traci R Raybon | Occupational Therapist | 1924 Hidden Valley, Tallahassee, FL 32308 | 2017-09-03 |
| Find all providers in zip 32308 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912359464 | A Life Recovery, Inc | Substance Abuse Rehabilitation Facility | 449 W Georgia St, Tallahassee, FL 32301-1011 | 2016-07-08 |
| 1497136717 | S K Kotei Consultants LLC | Substance Abuse Rehabilitation Facility | 1347 E Tennessee St, Tallahassee, FL 32308-5107 | 2015-06-11 |
| 1487619391 | Disc Village, Inc. | Substance Abuse Rehabilitation Facility | 3333 W Pensacola St, Tallahassee, FL 32304-2888 | 2006-04-20 |
| 1558854141 | A Life Recovery Center | Substance Abuse Rehabilitation Facility | 449 W Georgia St, Tallahassee, FL 32301 | 2018-06-08 |
| 1164953782 | Disc Village, Inc. | Substance Abuse Rehabilitation Facility | 2967 Natural Bridge Rd, Tallahassee, FL 32305-1806 | 2017-03-24 |
| 1689066086 | Apalachee Center, Inc. | Substance Abuse Rehabilitation Facility | 2634 Capital Cir Ne, Tallahassee, FL 32308-4106 | 2015-02-23 |
| 1457377376 | Disc Village, Inc. | Substance Abuse Rehabilitation Facility | 3333 W Pensacola St, Tallahassee, FL 32304-2888 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336747146 | Ascend Recovery Center | Substance Abuse Rehabilitation Facility | 5716 S Dixie Hwy, West Palm Beach, FL 33405-3607 | 2020-10-14 |
| 1427664366 | Noble Wellness, LLC | Substance Abuse Rehabilitation Facility | 402 Ne 10th Ter, Boca Raton, FL 33432-2940 | 2020-09-16 |
| 1477166494 | Sands Treatment Center LLC | Substance Abuse Rehabilitation Facility | 2100 Park Central Blvd N Ste 900, Pompano Beach, FL 33064-2242 | 2020-08-28 |
| 1750991923 | Aspen Behavioral Health LLC | Substance Abuse Rehabilitation Facility | 525 10th St Ste 503, Lake Park, FL 33403-3187 | 2020-08-03 |
| 1538786991 | Cypress Wellness Retreat LLC | Substance Abuse Rehabilitation Facility | 180 Elaine Rd, West Palm Beach, FL 33413-2311 | 2020-07-01 |
| 1528680998 | Northlake Recovery, LLC | Substance Abuse Rehabilitation Facility | 8841 Lyndall Ln, Palm Beach Gardens, FL 33403-1639 | 2020-05-08 |
| 1629602040 | Adventist Health System-sunbelt, Inc | Substance Abuse Rehabilitation Facility | 212 Eslinger Way, Sanford, FL 32773-6187 | 2020-02-25 |
| 1326678046 | The Treatment Center By The Recovery Village, LLC | Substance Abuse Rehabilitation Facility | 8585 Sunset Dr Ste 202, Miami, FL 33143-3746 | 2020-01-22 |
| 1932739802 | Standard of Care LLC | Substance Abuse Rehabilitation Facility | 721 Us Highway 1 Ste 114-115, North Palm Beach, FL 33408-4512 | 2020-01-20 |
| 1518505411 | Dialogical Interaction Recovery, Corp. | Substance Abuse Rehabilitation Facility | 515 N. Washington Street, Jacksonville, FL 32202 | 2019-12-11 |
| Find all providers with the same taxonomy | ||||
| City | TALLAHASSEE |
| Zip Code | 32308 |
Please comment or provide details below to improve the information on INTERNAL MEDICINE AND PEDIATRICS ASSOCIATESOF TALLAHASSEE INC.
| 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.