NPIMap

Organization Active NPI

Primary Care Medical Services of Poinciana, Inc.

  • Community/Behavioral Health Agency
  • Kissimmee, FL
National Provider Identifier
1043873342
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
PRIMARY CARE MEDICAL SERVICES OF POINCIANA, INC.
Practice address
1501-1507 Bill Beck Blvd
Kissimmee, FL 34744
Phone
(407) 943-8600
NPI assigned
Apr 22, 2019
Organization subpart
Yes
Parent organization
PRIMARY CARE MEDICAL SERVICES OF POINCIANA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Authorized official

Name
Belinda Johnson-Cornett
Title
Ceo
Phone
(407) 943-8600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Federally Qualified Health Center (FQHC) 261QF0400X

Addresses

Primary practice location

1501-1507 Bill Beck Blvd
Kissimmee, FL 34744

Mailing address

1877 Fortune Rd
Kissimmee, FL 34744-4428
Phone (407) 943-8600

Other practice location 1

1050 Grape Ave
Saint Cloud, FL 34769-3965
Phone (407) 943-8600

Other practice location 2

2622 Simpson Rd
Kissimmee, FL 34744-4674
Phone (407) 943-8600

Other practice location 3

109 N Doverplum Ave
Kissimmee, FL 34758-3309
Phone (407) 943-8600

Other practice location 4

1703 Business Center Ln
Kissimmee, FL 34758-1801
Phone (407) 943-8600

Other names 1

  • Osceola Community Health Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Primary Care Medical Services of Poinciana Inc13 organizations share this tax ID, including this one
Part of
Primary Care Medical Services of Poinciana Inc

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2622 Simpson Rd
Kissimmee, FL 34744

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26532/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 2

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": "1555891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1043873342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1877 FORTUNE RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444428",
            "telephone_number": "407-943-8600",
            "fax_number": "407-932-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501-1507 BILL BECK BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34744",
            "telephone_number": "407-943-8600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Grape Ave",
            "address_purpose": "LOCATION",
            "city": "Saint Cloud",
            "state": "FL",
            "postal_code": "347693965",
            "country_code": "US",
            "telephone_number": "407-943-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2622 Simpson Rd",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347444674",
            "country_code": "US",
            "telephone_number": "407-943-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 N Doverplum Ave",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347583309",
            "country_code": "US",
            "telephone_number": "407-943-8600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1703 Business Center Ln",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "347581801",
            "country_code": "US",
            "telephone_number": "407-943-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIMARY CARE MEDICAL SERVICES OF POINCIANA, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIMARY CARE MEDICAL SERVICES OF POINCIANA INC",
        "enumeration_date": "2019-04-22",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "JOHNSON-CORNETT",
        "authorized_official_first_name": "BELINDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-943-8600"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Osceola Community Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.