NPIMap

Organization Active NPI

Physicians Housecall Team, LLC

  • Family Medicine Physician
  • Winter Haven, FL
National Provider Identifier
1013300912
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS9203 Issued in FL
Legal business name
PHYSICIANS HOUSECALL TEAM, LLC
Practice address
1225 Havendale Blvd NW
#338
Winter Haven, FL 33881-1349
Phone
(863) 268-2921
Fax
(863) 268-2923
NPI assigned
Mar 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Authorized official

Name
Byron Renard Dean, D.O.
Title
Ceo
Phone
(407) 719-6673

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X OS9203 FL Primary

Addresses

Primary practice location

1225 Havendale Blvd NW
#338
Winter Haven, FL 33881-1349

Mailing address

3616 Harden Blvd
#311
Lakeland, FL 33803-5938
Phone (863) 268-2921

Other identifiers 1

IdentifierTypeStateIssuer
245345600MedicaidFL

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CJAFAD

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429142400000",
    "number": "1013300912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3616 HARDEN BLVD",
            "address_2": "#311",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338035938",
            "telephone_number": "863-268-2921",
            "fax_number": "863-268-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 HAVENDALE BLVD NW",
            "address_2": "#338",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338811349",
            "telephone_number": "863-268-2921",
            "fax_number": "863-268-2923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS HOUSECALL TEAM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-04-16",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "BYRON",
        "authorized_official_middle_name": "RENARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-719-6673",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS9203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "245345600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.