NPIMap

Organization Active NPI

Florida Department of Health

  • Community Health Worker
  • Quincy, FL
National Provider Identifier
1013247550
Registry record updated Jan 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
RN9169219 Issued in FL
Legal business name
FLORIDA DEPARTMENT OF HEALTH
Practice address
278 Lasalle Lefall Dr
Quincy, FL 32351-5324
Phone
(850) 875-7200
Fax
(850) 875-7210
NPI assigned
Jan 6, 2010
Last updated
Jan 6, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miriam Gwathney, D.O.
Title
Medical Director
Phone
(850) 875-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 172V00000X RN9169219 FL Primary

Addresses

Primary practice location

278 Lasalle Lefall Dr
Quincy, FL 32351-5324

Mailing address

278 Lasalle Lefall Dr
Quincy, FL 32351-5324
Phone (850) 875-7200

National Provider Directory

National Provider Directory
Tax ID family
Agape Community Health185 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Locations

278 Lasalle Leffall Dr
Quincy, FL 32351
Phone (850) 539-2888

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1013247550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 LASALLE LEFALL DR",
            "city": "QUINCY",
            "state": "FL",
            "postal_code": "323515324",
            "telephone_number": "850-875-7200",
            "fax_number": "850-875-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 LASALLE LEFALL DR",
            "city": "QUINCY",
            "state": "FL",
            "postal_code": "323515324",
            "telephone_number": "850-875-7200",
            "fax_number": "850-875-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "GWATHNEY",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "850-875-7200",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Community Health Worker",
            "state": "FL",
            "license": "RN9169219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.