Timothy Pursley (NPI# 1376646562, PAC ID# 5294804670) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1376646562 |
| PAC ID by PECOS | 5294804670 |
| Professional Enrollment ID | I20100921001241 |
| Full Name | Timothy Pursley |
| Organization Legal Name | MAITLAND FAMILY PRACTICE |
| Address |
402 Lake Howell Rd Maitland FL 32751-5907 |
| Phone Number | 4076284312 |
| Gender | M |
| Medical School | LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1994 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 5597889139 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100007 | FLORIDA HOSPITAL |
| 100006 | ORLANDO HEALTH |
| Address | Phone | Organization |
|---|---|---|
| 402 Lake Howell Rd, Maitland, FL 32751-5907 | 4076284312 | MAITLAND FAMILY PRACTICE |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PHCDRR_1 | Immunization Registry Reporting | % | |
| ACI_EC_TRANS_PHCDRR_3 | Specialized Registry Reporting | % | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | MAITLAND FAMILY PRACTICE |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer L Sams | Nurse Practitioner | Maitland Family Practice | 402 Lake Howell Rd, Maitland, FL 32751-5907 |
| Eddie Waldheim | Family Medicine | Maitland Family Practice | 402 Lake Howell Rd, Maitland, FL 32751-5907 |
| Melanie Serafine | Nurse Practitioner | Maitland Family Practice | 402 Lake Howell Rd, Maitland, FL 32751-5907 |
| Street Address |
402 LAKE HOWELL RD |
| City | MAITLAND |
| State | FL |
| Zip | 32751-5907 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer L Sams | Nurse Practitioner | Maitland Family Practice | 402 Lake Howell Rd, Maitland, FL 32751-5907 |
| Eddie Waldheim | Family Medicine | Maitland Family Practice | 402 Lake Howell Rd, Maitland, FL 32751-5907 |
| Melanie Serafine | Nurse Practitioner | Maitland Family Practice | 402 Lake Howell Rd, Maitland, FL 32751-5907 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jean Ruth Fairchild | Physician Assistant | Steve Nguyen Md Pa | 1640 N Maitland Ave, Suite 1000, Maitland, FL 32751-3320 |
| Marilyne Etienne | Physician Assistant | Steve Nguyen Md Pa | 1640 N Maitland Ave, Suite 1000, Maitland, FL 32751-3320 |
| Amanda L Rogan | Physician Assistant | Steve Nguyen Md Pa | 1640 N Maitland Ave, Suite 1000, Maitland, FL 32751-3320 |
| Kelly A Higgins | Nurse Practitioner | 1941 Mohican Trl, Maitland, FL 32751-3729 | |
| George J Hopkins Iii | Certified Registered Nurse Anesthetist (crna) | Mnh Gi Anesthesia and Pain Management LLC | 1101 N Maitland Ave, Maitland, FL 32751-4346 |
| Pamela A Barden | Certified Registered Nurse Anesthetist (crna) | Mnh Gi Anesthesia and Pain Management LLC | 1101 N Maitland Ave, Maitland, FL 32751-4346 |
| Allison M Amore | Obstetrics/gynecology | Florida Woman Care LLC | 531 N Maitland Ave, Maitland, FL 32751-4421 |
| John W Van Wert | Obstetrics/gynecology | Florida Woman Care LLC | 531 N Maitland Ave, Maitland, FL 32751-4421 |
| Rita E Eye | Obstetrics/gynecology | Florida Woman Care LLC | 531 N Maitland Ave, Maitland, FL 32751-4421 |
| Lisa S Felix | Certified Nurse Midwife (cnm) | Florida Woman Care LLC | 531 N Maitland Ave, Maitland, FL 32751-4421 |
| Find all physicians in zip 32751 | |||
| City | MAITLAND |
| Zip Code | 32751 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | MAITLAND + FAMILY MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.