THREE RIVERS MEDICAL INC. (NPI# 1710049671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710049671 |
| Entity Type | Organization |
| Organization Name | THREE RIVERS MEDICAL INC. |
| Practice Address |
208 Suwannee Ave Nw Branford FL 32008-3265 |
| Practice Telephone | 3869351607 |
| Practice Fax Number | 3869351667 |
| Mailing Telephone | 3869351607 |
| Mailing Fax Number | 3869351667 |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2010-02-04 |
| Authorized Official Name | MS. PEGGY L MALONEY (PRACTICE MANAGER) |
| Authorized Official Telephone | 3869351607 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2934442 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 303822000 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Three Rivers Medical Inc. | 1507 Mark Twain Lane, Steamboat Springs, CO 80487 |
| Street Address |
208 SUWANNEE AVE NW |
| City | BRANFORD |
| State | FL |
| Zip Code | 32008-3265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942254651 | Rodney Lee Scyphers | Nurse Practitioner | 208 Suwannee Ave Nw, Branford, FL 32008-3265 | 2006-05-19 |
| 1225082332 | Three Rivers Medical | Clinic/Center | 208 Suwannee Ave Nw, Branford, FL 32008-3265 | 2006-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073130548 | Kellie Ann White | Nurse Practitioner | 103 Us Highway 27, Branford, FL 32008 | 2020-07-01 |
| 1609382795 | Kristin Hope Mcintosh | Nurse Practitioner | 103 Us-27, Branford, FL 32008 | 2017-12-27 |
| 1457749897 | Holly M Reed | Registered Nurse | 103 Us Hwy 27, Branford, FL 32008 | 2015-01-08 |
| 1891874707 | Florida Department of Health | Public Health or Welfare | 120 Suwannee Ave, Branford, FL 32008 | 2006-11-02 |
| 1194140319 | Janice Baucom | Nurse Practitioner | 109 S.w. Savannah Ave., Branford, FL 32008 | 2014-02-25 |
| 1659487049 | Nancy Lee Cooper | Chiropractor | 13159 East Us Hwy 27, Branford, FL 32008-0396 | 2006-08-21 |
| 1568657716 | Cooper Chiropractic, Inc. | Chiropractor | 13159 East Us Hwy 27, Branford, FL 32008-0396 | 2007-09-11 |
| 1437461969 | Tracy D. Lamb | Developmental Therapist | 26082 Hwy 247, Branford, FL 32008-0744 | 2010-07-13 |
| 1639199243 | Bienvenido Samera | Family Medicine | 303 Suwannee Ave, Branford, FL 32008-0846 | 2006-07-20 |
| 1881246155 | Ajm Transport Company LLC | Non-emergency Medical Transport (VAN) | 4352 282nd Ter, Branford, FL 32008-2374 | 2019-07-16 |
| Find all providers in zip 32008 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073130548 | Kellie Ann White | Nurse Practitioner | 103 Us Highway 27, Branford, FL 32008 | 2020-07-01 |
| 1578107017 | Laura N Cifarelli | Nurse Practitioner | 62 Laurel Hill Rd, Branford, CT 06405-2408 | 2019-10-28 |
| 1679128102 | Roseanna Petonito | Nurse Practitioner | 251 W Main St Ste 5c, Branford, CT 06405-4047 | 2019-08-01 |
| 1407409246 | Kristen Murusky | Nurse Practitioner | 251 W Main St Ste Branford, Branford, CT 06405-4047 | 2019-07-22 |
| 1689143802 | Kyle Lynn Blomberg | Nurse Practitioner | 500 E Main St Ste 212, Branford, CT 06405-2937 | 2018-11-16 |
| 1609382795 | Kristin Hope Mcintosh | Nurse Practitioner | 103 Us-27, Branford, FL 32008 | 2017-12-27 |
| 1902341456 | James Joseph Cartwright | Nurse Practitioner | 25632 83rd Rd, Branford, FL 32008-2622 | 2016-12-19 |
| 1437538683 | Monica D'aria | Nurse Practitioner | 4 Brushy Plain Rd Ste 519, Branford, CT 06405-6000 | 2015-05-20 |
| 1942254651 | Rodney Lee Scyphers | Nurse Practitioner | 208 Suwannee Ave Nw, Branford, FL 32008-3265 | 2006-05-19 |
| 1003894734 | Maura Jane D'andrea | Nurse Practitioner | 19 Ozone Rd, Branford, CT 06405-5509 | 2006-01-03 |
| Find all providers in BRANFORD | ||||
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| 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.