Kemshol Medical Center PA

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

KEMSHOL MEDICAL CENTER PA

Practice address

984 Orange Ave
Daytona Beach, FL 32114-4667

Phone

(386) 226-3008

Fax

(386) 226-3044

NPI assigned

Jun 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Olubukunola Collins Thomas, M.D

Title

President

Phone

(407) 756-4541

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1181952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193443200000",
    "number": "1023213469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "984 ORANGE AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144667",
            "telephone_number": "386-226-3008",
            "fax_number": "386-226-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 ORANGE AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321144667",
            "telephone_number": "386-226-3008",
            "fax_number": "386-226-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEMSHOL MEDICAL CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-16",
        "last_updated": "2007-10-27",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "OLUBUKUNOLA",
        "authorized_official_middle_name": "COLLINS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-756-4541",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coreen Kelly
• Daniel William Kelly, PA-C
• Elizabeth Victoria Kelly, PA STUDENT
• Shawn Demian Kelly, APRN
• Robert Kemp, LMHC
• Ruth Kent, PT
• Julia Kerbs
• Sepeedeh Zahra Kermalli, DO
• J Patrick Kerr, CRNA
• Jeanne Marie Kerr, MSN APRN NP-C

• Clinic/Center in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2007; 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.