NPIMap

Organization Active NPI

Citrus Multi Care LLC

  • Multi-Specialty Clinic/Center
  • Crystal River, FL
National Provider Identifier
1073099461
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CITRUS MULTI CARE LLC
Practice address
255 SE 7TH Ave Ste 1
Crystal River, FL 34429-4848
Phone
(352) 794-6385
NPI assigned
Jul 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Authorized official

Name
Brandie UnderwoodNPI 1538645122
Title
Owner
Phone
(352) 302-2223

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 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X
MOHS-Micrographic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0101X
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X
Procedural Dermatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207NS0135X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

255 SE 7TH Ave Ste 1
Crystal River, FL 34429-4848

Mailing address

255 SE 7TH Ave Ste 3
Crystal River, FL 34429-4848
Phone (352) 302-2223

Other practice location 1

255 SE 7th Ave Ste 3
Crystal River, FL 34429
Phone (352) 302-2223

Other names 2

  • Citrus Care Clinic LLC Doing business as
  • Citrus Dermatology LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190617000453 FL Part B Supplier - Clinic/Group Practice 8729311204 Receives reassigned benefits from 8 practitioners
Practice locations: Crystal River, FL

National Provider Directory

National Provider Directory

Locations

255 SE 7th Ave
Ste 3
Crystal River, FL 34429
Phone (352) 302-2223

Practitioners & affiliated clinicians

Practitioners 10

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": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636070400000",
    "number": "1073099461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 SE 7TH AVE STE 3",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344294848",
            "telephone_number": "352-302-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 SE 7TH AVE STE 1",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344294848",
            "telephone_number": "352-794-6385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 SE 7th Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Crystal River",
            "state": "FL",
            "postal_code": "34429",
            "country_code": "US",
            "telephone_number": "352-302-2223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CITRUS MULTI CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "BRANDIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-302-2223"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Citrus Care Clinic LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Citrus Care Clinic LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Citrus Dermatology LLC",
            "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 Nov 5, 2021; 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.