NPIMap

Organization Active NPI

Ocala Health Trauma, LLC

  • Trauma Surgery Physician
  • Ocala, FL
National Provider Identifier
1093063869
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
Legal business name
OCALA HEALTH TRAUMA, LLC
Practice address
205 SE 14TH PL
Ocala, FL 34471-4341
Phone
(352) 629-1800
NPI assigned
Aug 27, 2012
Last updated
Aug 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Authorized official

Name
Mickey S Pickler
Title
Authorized Official
Phone
(850) 523-2117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Trauma Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0127X Primary

Addresses

Primary practice location

205 SE 14TH PL
Ocala, FL 34471-4341

Mailing address

205 SE 14TH PL
Ocala, FL 34471-4341
Phone (352) 629-1800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121026000010 FL Part B Supplier - Clinic/Group Practice 2769632850 Receives reassigned benefits from 22 practitioners
Practice locations: Lake City, FL; Ocala, FL; Palatka, FL

National Provider Directory

National Provider Directory

Locations

1500 SE Magnolia Ext
Ste 204
Ocala, FL 34471
Phone (352) 351-1022

1500 SE Magnolia Ext
Ste 205
Ocala, FL 34471
Phone (352) 629-1800

Practitioners & affiliated clinicians

Practitioners 35

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 35

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346025600000",
    "number": "1093063869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 SE 14TH PL",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714341",
            "telephone_number": "352-629-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SE 14TH PL",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714341",
            "telephone_number": "352-629-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCALA HEALTH TRAUMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-08-27",
        "status": "A",
        "authorized_official_last_name": "PICKLER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "850-523-2117"
    },
    "taxonomies": [
        {
            "code": "2086S0127X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Trauma Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.