NPIMap

Organization Active NPI

Nature Coast High Risk Medical Management LLC

Doing business as Nature Coast Provider Outreach

  • Family Medicine Physician
  • Crystal River, FL
National Provider Identifier
1013377795
Registry record updated Jun 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS10486 Issued in FL
Legal business name
NATURE COAST HIGH RISK MEDICAL MANAGEMENT LLC
Doing business as
Nature Coast Provider Outreach
Practice address
7562 W Gulf to Lake Hwy
Crystal River, FL 34429-7840
Phone
(352) 436-4328
Fax
(352) 260-0960
NPI assigned
Feb 24, 2016
Last updated
Jun 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2020

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

Authorized official

Name
Kenneth L Savage Jr., DONPI 1588813661
Title
Owner
Phone
(352) 436-4328

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS10486 FL Primary

Addresses

Primary practice location

7562 W Gulf to Lake Hwy
Crystal River, FL 34429-7840

Mailing address

7562 W Gulf to Lake Hwy
Crystal River, FL 34429-7840
Phone (352) 436-4328

Other identifiers 1

IdentifierTypeStateIssuer
OS10486OtherFLSTATE MEDICAL LICENSE

Other names 1

  • Nature Coast Provider Outreach Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160801000006 FL Part B Supplier - Clinic/Group Practice 1759674658 Receives reassigned benefits from 13 practitioners
Practice locations: Inverness, FL; Crystal River, FL

National Provider Directory

National Provider Directory

Locations

905 N Citrus Ave
Crystal River, FL 34428
Phone (352) 563-5767

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592265600000",
    "number": "1013377795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7562 W GULF TO LAKE HWY",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344297840",
            "telephone_number": "352-436-4328",
            "fax_number": "352-260-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7562 W GULF TO LAKE HWY",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344297840",
            "telephone_number": "352-436-4328",
            "fax_number": "352-260-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATURE COAST HIGH RISK MEDICAL MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-24",
        "last_updated": "2020-06-16",
        "certification_date": "2020-06-16",
        "status": "A",
        "authorized_official_last_name": "SAVAGE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-436-4328",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS10486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "OS10486",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nature Coast Provider Outreach",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crystal River, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.