FAMILY HEALTH CENTER OF COLUMBIA COUNTY, INC. (NPI# 1962464248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962464248 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTH CENTER OF COLUMBIA COUNTY, INC. |
| Other Organization Name | SELECTED |
| Practice Address |
173 Nw Albritton Ln Lake City FL 32055-0249 |
| Mailing Address |
Po Box 249 Lake City FL 32056-0249 |
| Practice Telephone | 3867585552 |
| Practice Fax Number | 3867529143 |
| Mailing Telephone | 3867585552 |
| Mailing Fax Number | 3867529143 |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2010-10-15 |
| Authorized Official Name | MR. JOHN T MYLES (CEO) |
| Authorized Official Telephone | 3867585552 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA0003548 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 207Q00000X | Family Medicine | ME92183 | FL | Allopathic & Osteopathic Physicians |
| N | 363A00000X | Physician Assistant | PA9101298 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 1181972 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | ARNP2908802 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 261Q00000X | Clinic/Center | 5080000065 | FL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | STATE LICENSE | ME92183 | 01 |
| FL | 292277100 | 05 | |
| FL | FLORIDA LICENSE | PA0003548 | 01 |
| FL | FLORIDA LICENSE | 1181972 | 01 |
| FL | 290374100 | 05 | |
| FL | 023552300 | 05 | |
| FL | FLORIDA LICENSE | PA9101298 | 01 |
| FL | 033364600 | 05 | |
| FL | 273713200 | 05 | |
| FL | ORIGINAL LICENSE | 5080000065 | 01 |
| Other Name | Type Code |
|---|---|
| selected | Doing Business As Name - Organization |
| Street Address |
173 NW ALBRITTON LN |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32055-0249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891795175 | John P Odonnell | Physician Assistant | 173 Nw Albritton Ln, Lake City, FL 32055-4451 | 2005-07-28 |
| 1982264438 | Pamela Lima | Dentist | 173 Nw Albritton Ln, Lake City, FL 32055-4451 | 2019-06-17 |
| 1205232808 | Althea L Robinson | Nurse Practitioner | 173 Nw Albritton Ln, Lake City, FL 32055-4451 | 2014-11-07 |
| 1124442355 | Trenton Medical Center, Inc. | Family Medicine | 173 Nw Albritton Ln, Lake City, FL 32055-4451 | 2014-02-07 |
| 1730452590 | Aleyda America Ferrer-duchesne | Dentist | 173 Nw Albritton Ln, Lake City, FL 32055-4451 | 2012-02-09 |
| 1053430314 | Angela Tomlinson | Registered Nurse | 173 Nw Albritton Ln, Lake City, FL 32055-4451 | 2007-03-28 |
| 1528162047 | Stanley Steven Jones | Dentist | 173 Nw Albritton Ln, Lake City, FL 32055-4451 | 2006-09-13 |
| 1487683074 | Sparkle Green | Nurse Practitioner | 173 Nw Albritton Ln, Lake City, FL 32055-4451 | 2006-07-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114439510 | Melissa Fay Peters | Nurse Practitioner | 5085 West Us Highway 90, Lake City, FL 32055 | 2017-10-26 |
| 1851801765 | Stephanie Jo Nogle | Occupational Therapist | Brooks Americare: 4251 Nw American Ln, #103, Lake City, FL 32055 | 2017-10-05 |
| 1831617273 | Erica Mayo | Pharmacist | 4846 Nw Lake Jeffery Rd., Lake City, FL 32055 | 2017-09-06 |
| 1144759333 | Jerry Hamilton Cheesman | Dentist | 217 Ne Franklin Sreet, Lake City, FL 32055 | 2017-06-09 |
| 1487183745 | Joshua Allore | Dentist | 2970 W Us Highway 90., Lake City, FL 32055 | 2017-06-08 |
| 1497298418 | Careing Hands | Preferred Provider Organization | 1471nw Queen Rd, Lakecity, FL 32055 | 2016-11-22 |
| 1881148278 | Corniqueca Stewart-simmons | Nurse Practitioner | 340 Nw Commerce Drive, Lake City, FL 32055 | 2016-08-15 |
| 1164809141 | Latasha Harten-jones | Licensed Practical Nurse | 443 Ne Sims Dr, Lake City, FL 32055 | 2015-04-29 |
| 1154716447 | Lindsey Morton | Counselor | 219 Se Baya Avenue, Lake City, FL 32055 | 2015-04-02 |
| 1124439351 | Tynette Jordan | Counselor | 708 N.w Wilson St., Lake City, FL 32055 | 2014-05-09 |
| Find all providers in zip 32055 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1205327939 | Neurology Center of North Florida, LLC | Clinic/Center | 426 Sw Commerce Dr Ste 101, Lake City, FL 32025-1506 | 2018-05-30 |
| 1568966414 | Serenity Alternative Healthcare & Acupuncture Center | Clinic/Center | 1009 Sw Main Blvd Ste 110, Lake City, FL 32025-5784 | 2018-03-23 |
| 1386957942 | Lake City Diagnostic Imaging, Inc. | Clinic/Center | 148 Sauls St, Lake City, SC 29560-2631 | 2010-07-23 |
| 1194900936 | Valkos Chiropractic Office, LLC | Clinic/Center | 106 S Washington St, Lake City, MN 55041-1034 | 2007-12-28 |
| 1730275538 | Shands At Lake Shore Inc | Clinic/Center | 368 Ne Franklin St, Lake City, FL 32055-3088 | 2006-10-05 |
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| 1659979243 | B&b Medical Center Inc | Clinic/Center | 219 Ne 8th Ave, Hialeah, FL 33010-5116 | 2020-10-15 |
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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.