Ally Healthcare, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ALLY HEALTHCARE, LLC

Practice address

5503 E Busch Blvd
Temple Terrace, FL 33617-5419

Phone

(813) 200-7717

Fax

(813) 985-8500

NPI assigned

Mar 22, 2012

Last updated

Mar 22, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Colleen Campbell, MD

Title

Owner/Physician

Phone

(813) 200-7717

Specialties & licenses 1

Addresses

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12591/brand/1/csg/1/fhir/r4

Practitioners 1

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.

• Mandy M Ciccarello, PA

  • Medical Physician Assistant
  • Lutz, FL
  • NPI 1841368479
  NPD

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332374400000",
    "number": "1073889176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5503 E BUSCH BLVD",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336175419",
            "telephone_number": "813-200-7717",
            "fax_number": "813-985-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5503 E BUSCH BLVD",
            "city": "TEMPLE TERRACE",
            "state": "FL",
            "postal_code": "336175419",
            "telephone_number": "813-200-7717",
            "fax_number": "813-985-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLY HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-22",
        "last_updated": "2012-03-22",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "813-200-7717",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Petra Allen, BCBA
• Jesse William Allert, M.D.
• Victoria Allman, PA-C
• Janet Almaguer Pena
• Aiya Almogaber, PHARMD
• Alpha Counseling
• Alternative Care Group LLC
• Douber Altidor, PTA

• Primary Care Clinic/Center in Temple Terrace, FL
• Providers in Temple Terrace, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2012; 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.