OUTREACH HEALTH INCORPORATED (NPI# 1528699352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528699352 |
| Entity Type | Organization |
| Organization Name | OUTREACH HEALTH INCORPORATED |
| Practice Address |
240 N Frederick Ave Daytona Beach FL 32114-3400 |
| Practice Telephone | 3862555569 |
| Practice Fax Number | 3862571245 |
| Mailing Telephone | 3862555569 |
| Mailing Fax Number | 3862571245 |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2020-01-30 |
| Authorized Official Name | DR. CHESTER LEE WILSON JR. (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3866750098 |
| Authorized Official Credential | ED.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
240 N FREDERICK AVE |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-3400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720260722 | Outreach Community Care Network | Case Management | 240 N Frederick Ave, Suite A, Daytona Beach, FL 32114 | 2007-11-30 |
| 1164047106 | Kristin Crumbley | Counselor | 240 N Frederick Ave, Daytona Beach, FL 32114 | 2020-06-16 |
| 1962048447 | The Levi Long Sickle Cell Association, Inc | Case Management | 240 N Frederick Ave, Daytona Beach, FL 32114-3400 | 2019-11-20 |
| 1225699143 | Tanya Leshea Williams | Pharmacist | 240 N Frederick Ave, Daytona Beach, FL 32114-3400 | 2019-06-21 |
| 1023678539 | Chester Wilson Jr. | Counselor | 240 N Frederick Ave, Daytona Beach, FL 32114-3400 | 2019-06-17 |
| 1225569973 | Wendy Seavers | Community Health Worker | 240 N Frederick Ave, Daytona Beach, FL 32114-3400 | 2017-03-24 |
| 1841736964 | Outreach Community Care Network Inc | Case Management | 240 N Frederick Ave, Daytona Beach, FL 32114-3400 | 2017-01-12 |
| 1639582992 | Jane Marti Martin | Case Manager/Care Coordinator | 240 N Frederick Ave, Daytona Beach, FL 32114-3400 | 2014-06-04 |
| 1992116495 | Tony L Broxton | Case Manager/Care Coordinator | 240 N Frederick Ave, Daytona Beach, FL 32114-3400 | 2014-05-19 |
| 1952738049 | Outreach Community Care Network, Inc. | Internal Medicine | 240 N Frederick Ave, Suite D, Daytona Beach, FL 32114-3400 | 2013-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598155830 | Monica Edith Cantu | General Practice | 1890 Lpga Blvd Ste 130, Primecare At Twin Lakes, Daytona Beach, FL 32117-7131 | 2015-01-26 |
| 1255603189 | A1a Medical | General Practice | 1401 North Atlantic Avenue, Daytona Beach, FL 32118 | 2012-02-08 |
| 1669630422 | Cesar Arturo Calderon | General Practice | 3950 Tiger Bay Rd, Tomoka Correctional Institution Medical Dept, Daytona Beach, FL 32124-1098 | 2008-05-29 |
| 1750582151 | Milton Mendez | General Practice | 3950 Tiger Bay Road, Medical Department Tomoka Correctional Institution, Daytona Beach, FL 32124-1042 | 2007-05-31 |
| 1962579391 | Evan Demetrios Carratt | General Practice | 1243 S Ridgewood Ave, Daytona Beach, FL 32114-6127 | 2006-11-29 |
| 1508833104 | Luz M Alicea Berrios | General Practice | 1425 Dunn Ave, Daytona Beach, FL 32114 | 2006-03-02 |
| 1760763114 | Angel Emanuel Benitez | General Practice | 1425 Dunn Ave, Daytona Beach, FL 32114-1437 | 2011-08-30 |
| 1578699351 | Loretha King | General Practice | 143 Executive Cir, Daytona Beach, FL 32114-1180 | 2007-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033823 | Bless Medical Center of Nmb LLC | General Practice | 1400 Ne Miami Gardens Dr Ste 209, North Miami Beach, FL 33179-4844 | 2020-11-02 |
| 1982203634 | Central Florida Wellness LLC | General Practice | 15516 W Colonial Dr Ste 111, Winter Garden, FL 34787-9558 | 2020-10-23 |
| 1760080212 | Summit Health Multi Specialty of Florida LLC | General Practice | 1881 W Kennedy Blvd Ste D, Tampa, FL 33606-1611 | 2020-10-15 |
| 1376140772 | Amy Wrenn | General Practice | 155 Cranes Roost Blvd Ste 2020-a, Altamonte Springs, FL 32701-3468 | 2020-10-08 |
| 1992302574 | Avita Medical Clinic, LLC | General Practice | 14831 N Florida Ave, Tampa, FL 33613-1825 | 2020-10-06 |
| 1568069672 | Ernesto Oscar Gonzalez Pupo | General Practice | 14420 Sw 22nd St, Miami, FL 33175-6338 | 2020-10-02 |
| 1508463779 | Ashley Zanders Walton | General Practice | 75 Foxfire Ct, Quincy, FL 32351-7293 | 2020-10-01 |
| 1730796830 | Brid M Wade | General Practice | 3199 Cornell Dr, Gulf Breeze, FL 32563-2785 | 2020-09-23 |
| 1902412786 | New Era Medical Pllc | General Practice | 628 Cleveland St Ste A, Clearwater, FL 33755-6603 | 2020-09-17 |
| 1417562414 | Jl Laria Aprn Pa | General Practice | 5751a Sw 40th St, Miami, FL 33155-5301 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
Please comment or provide details below to improve the information on OUTREACH HEALTH INCORPORATED.
| 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.