CAPITAL REGIONAL MEDICAL GROUP (NPI# 1790181550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790181550 |
Entity Type | Organization |
Organization Name | CAPITAL REGIONAL MEDICAL GROUP |
Practice Address |
2770 Capital Medical Blvd Suite 200 Tallahassee FL 32308-8417 |
Mailing Address |
363 Milestone Dr Tallahassee FL 32312-3575 |
Practice Telephone | 8508788235 |
Mailing Telephone | 9544457760 |
Enumeration Date | 2014-11-06 |
Last Update Date | 2014-11-06 |
Authorized Official Name | DR. RICHARD THACKER (PHYSICIAN) |
Authorized Official Telephone | 8508788235 |
Authorized Official Credential | D.O. |
Is Organization Subpart | Y |
Parent Organization Name | CAPITAL REGIONAL MEDICAL CENTER |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 305R00000X | Preferred Provider Organization | ARNP9188795 | FL | Managed Care Organizations |
Street Address |
2770 CAPITAL MEDICAL BLVD SUITE 200 |
City | TALLAHASSEE |
State | FL |
Zip Code | 32308-8417 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114920261 | Richard Randall Thacker | Internal Medicine | 2770 Capital Medical Blvd, Ste 200, Tallahassee, FL 32308-8417 | 2005-05-23 |
1760880082 | Paul Modafferi | Nurse Practitioner | 2770 Capital Medical Blvd, Tallahassee, FL 32308-8417 | 2014-12-18 |
1831520063 | Molly Seal | Nurse Practitioner | 2770 Capital Medical Blvd, Suite 200, Tallahassee, FL 32308-8417 | 2013-12-13 |
1063758944 | Jennifer Russell | Nurse Practitioner | 2770 Capital Medical Blvd, Suite 200, Tallahassee, FL 32308-8417 | 2012-12-20 |
1740449891 | Jeffrey Shepard Kirk | Specialist | 2770 Capital Medical Blvd, Suite 200, Tallahassee, FL 32308-8417 | 2008-06-04 |
1023222361 | Grant Center Hospital of Ocala Inc | Internal Medicine | 2770 Capital Medical Blvd, Suite 200, Tallahassee, FL 32308-8417 | 2007-05-09 |
1619030558 | Stephanie Lee | Obstetrics & Gynecology | 2770 Capital Medical Blvd, Suite 110, Tallahassee, FL 32308-8417 | 2006-12-19 |
1336201771 | Sean F Fitzgerald | Surgery | 2770 Capital Medical Blvd, Suite 200 Capital Regional Spine Center, Tallahassee, FL 32308-8417 | 2006-12-14 |
1184724239 | Pain Institute of North Florida Pa | Pain Medicine | 2770 Capital Medical Blvd, Suite 100, Tallahassee, FL 32308-8417 | 2006-09-25 |
1750480380 | Tallahassee Gyn-oncology LLC | Obstetrics & Gynecology | 2770 Capital Medical Blvd, Suite 210, Tallahassee, FL 32308-8417 | 2006-09-21 |
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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 | 305R00000X |
Grouping | Managed Care Organizations |
Classification | Preferred Provider Organization |
A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
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1235602541 | Wc Doc-chasers | Preferred Provider Organization | 5220 69th St E, Palmetto, FL 34221-9397 | 2019-01-09 |
1114427390 | Xact Healthcare Solutions LLC | Preferred Provider Organization | 2400 Se Veterans Memorial Pkwy Ste 211, Port St Lucie, FL 34952-4890 | 2018-02-14 |
1598264798 | Mahogany Revue R&d Development Center | Preferred Provider Organization | 903 Ne Osceola Ave, Ocala, FL 34470-5208 | 2018-02-03 |
1982124020 | Unique Exceptional Services LLC | Preferred Provider Organization | 431 W Obispo Ave, Clewiston, FL 33440-4419 | 2017-06-20 |
Find all providers with the same taxonomy |
City | TALLAHASSEE |
Zip Code | 32308 |
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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.