CENTENNIAL MEDICAL GROUP (NPI# 1730682642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730682642 |
| Entity Type | Organization |
| Organization Name | CENTENNIAL MEDICAL GROUP |
| Practice Address |
1341 Bedford Drive Melbourne FL 32940 |
| Practice Telephone | 3216228031 |
| Practice Fax Number | 3216107487 |
| Mailing Telephone | 3216228031 |
| Mailing Fax Number | 3216107487 |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2018-03-16 |
| Authorized Official Name | STEPHEN M GIORGIANNI (OWNER) |
| Authorized Official Telephone | 3216228031 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598926677 | Centennial Medical Group | Pain Medicine | 4640 W Craig Rd, N Las Vegas, NV 89032-2743 | 2008-06-20 |
| 1073912010 | Centennial Medical Group | Pediatrics | 2579 Nw Edenbower Blvd, Roseburg, OR 97471-6220 | 2014-08-15 |
| 1265664742 | Centennial Medical Group | Surgery | 2570 Nw Edenbower Blvd, Suite 101, Roseburg, OR 97471-6214 | 2009-08-17 |
| 1497993695 | Centennial Medical Group | Pathology | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2009-01-26 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CENTENNIAL MEDICAL GROUP EAST, LLC | 2801 Nw Mercy Dr Ste 340, Roseburg, OR 97471-2348 |
| Oregon Corporations, Companies and Business Names | CENTENNIAL MEDICAL GROUP EAST, LLC | 2570 Nw Edenbower Blvd, Roseburg, OR 97471 |
| System for Award Management (SAM) Entities | CENTENNIAL MEDICAL GROUP INC | 2700 Stewart Pkwy, Roseburg, OR 97471-1281 |
| Oregon Corporations, Companies and Business Names | CENTENNIAL MEDICAL GROUP NORTH, LLC | 201 Medical Loop Ste 190, Roseburg, OR 97471 |
| Oregon Corporations, Companies and Business Names | CENTENNIAL MEDICAL GROUP WEST, LLC | 201 Medical Loop, Suite 190, Roseburg, OR 97471 |
| Oregon Corporations, Companies and Business Names | CENTENNIAL MEDICAL GROUP, INC. | 201 Medical Loop Suite 190, Roseburg, OR 97471 |
| System for Award Management (SAM) Entities | CENTENNIAL MEDICAL GROUP, P.A. | 8186 Lark Brown Rd Ste 201, Elkridge, MD 21075-6434 |
| Street Address |
1341 BEDFORD DRIVE |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700403649 | True Motion Physical Therapy and Wellness | Clinic/Center | 3536 Peninsula Circle, Mlebourne, FL 32940 | 2020-06-26 |
| 1568089431 | Live Gracefully Physio and Wellness, Pllc | Clinic/Center | 6470 Shadow Creek Trail, Apt 5204, Melbourne, FL 32940 | 2020-06-26 |
| 1295360592 | Hiteshi Patel | Pharmacist | 3134 Hummingbird Way, Melbourne, FL 32940 | 2020-03-06 |
| 1972133122 | Curtis Lynn Curbo | Social Worker | 3830 Fringetree Lane, Melbourne, FL 32940 | 2020-01-16 |
| 1861038283 | Medfast Urgent Care Centers, LLC | Clinic/Center | 5500 Stadium Parkway, Melbourne, FL 32940 | 2019-11-20 |
| 1134601594 | Caroline Grace Bennett | Behavior Technician | 5500 Murrell Rd Suite 100, Melbourne, FL 32940 | 2018-09-02 |
| 1356849251 | Executive Non-emergency Transportation, Inc. | Non-emergency Medical Transport (VAN) | 3155-02 Suntree Blvd, Melbourne, FL 32940 | 2018-01-25 |
| 1679081160 | Brevard Oaks Center, LLC | Skilled Nursing Facility | 2355 Vidina Drive, Viera, FL 32940 | 2018-01-18 |
| 1275045817 | Comfortable Care Dental Health Professionals. P.a. | Dentist | 6340 N Wickham Rd Ste 101, Melbourne, FL 32940 | 2017-11-03 |
| 1144746116 | Viera Modern Dentistry, Pa | Dentist | 2328 Citadel Way, Suite 101, Melbourne, FL 32940 | 2017-08-21 |
| Find all providers in zip 32940 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225682784 | Brevard Geriatrics, LLC | Family Medicine | 720 E New Haven Ave Suite 11, Melbourne, FL 32901-5474 | 2019-08-01 |
| 1063983138 | Transitional Care Management LLC | Family Medicine | 1341 Bedford Dr Ste B, Melbourne, FL 32940-1986 | 2018-12-16 |
| 1346392362 | Vasudeva R Nalipireddy | Family Medicine | 469 N Harbor City Blvd, Melbourne, FL 32935-6857 | 2007-01-18 |
| 1851355093 | Ningyi Huang | Family Medicine | 720 E New Haven Ave, Melbourne, FL 32901 | 2006-04-14 |
| 1730160607 | Paul R. Biggs | Family Medicine | 1223 Gateway Drive, Melbourne, FL 32901-2607 | 2005-11-08 |
| 1760478796 | Visalakshi Srinivasan | Family Medicine | 3661 S Babcock St, 2nd Floor, Melbourne, FL 32901-8903 | 2005-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821620618 | Heather J Cappello LLC | Family Medicine | 2571 Dick Wilson Dr, Sarasota, FL 34240-8722 | 2020-02-10 |
| 1922562933 | Bless Medical Center Corp | Family Medicine | 440 E Sample Road Suite 107, Pompano Beach, FL 33064 | 2019-01-23 |
| 1184137929 | Saint George Medical Center Inc | Family Medicine | 1118 Hospital Rd, Fort Walton Beach, FL 32547-6742 | 2017-11-15 |
| 1750835211 | Gainesville Geriatric Rehabilitation Medicine LLC | Family Medicine | 5002 Nw 15th Pl, Gainesville, FL 32605-4555 | 2016-08-12 |
| 1033570171 | Reliance Med, LLC | Family Medicine | 8450 Reymont St, Orlando, FL 32827-7430 | 2016-03-17 |
| 1013375062 | Kravitz Physician Services, P.a. | Family Medicine | 5150 Nw 82nd Ter, Coral Springs, FL 33067-2811 | 2016-02-05 |
| 1972968089 | Wm R George II Md Pa | Family Medicine | 327 Plaza Real Ste 307, Boca Raton, FL 33432-3944 | 2015-12-17 |
| 1710369020 | Robert N. Baskin, Md, P.a. | Family Medicine | 2108 N Golfview Dr, Plant City, FL 33566-6768 | 2015-06-23 |
| 1437557766 | Geriatric Care Associates LLC | Family Medicine | 10238 Sw 86th Cir, Suite 300, Ocala, FL 34481-7626 | 2014-12-18 |
| 1083026447 | Avalon Wellness Services LLC | Family Medicine | 6845 S Tropical Trl, Merritt Island, FL 32952-6512 | 2014-05-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CENTENNIAL MEDICAL GROUP.
| 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.