CAPITAL REGIONAL MEDICAL GROUP


Address: 2770 Capital Medical Blvd, Suite 200, Tallahassee, FL 32308-8417
Phone: 8508788235

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 305R00000X Preferred Provider Organization ARNP9188795 FL Managed Care Organizations

Office Location

Street Address 2770 CAPITAL MEDICAL BLVD
SUITE 200
City TALLAHASSEE
State FL
Zip Code 32308-8417

Providers in the same location

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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 305R00000X
Grouping Managed Care Organizations
Classification Preferred Provider Organization

Taxonomy Definition

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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1679185102 Crosspoint Medical LLC Preferred Provider Organization 8051 N Tamiami Trl Ste E6, Sarasota, FL 34243-2067 2020-08-17
1750991758 Leanne S Smith, Phd, Lmhc Preferred Provider Organization 104 Se 6th St Ste 2, Stuart, FL 34994-3038 2020-08-04
1932717089 Zei Gezunt Healthcare Pa Preferred Provider Organization 16001 Collins Ave Apt 2705, Sunny Isles Beach, FL 33160-5537 2020-07-15
1326508458 Wellness& Rejuvination Centre, P.a. Preferred Provider Organization 270 Nw Peacock Blvd Ste 114, Port St Lucie, FL 34986-1602 2019-03-24
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
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Competitor

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City TALLAHASSEE
Zip Code 32308

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Dataset Information

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.

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