NPIMap

Organization Active NPI

Neighborhood Medical Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Havana, FL
National Provider Identifier
1093207607
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NEIGHBORHOOD MEDICAL CENTER, INC
Practice address
1210 Kemp Rd
Havana, FL 32333-1938
Phone
(850) 539-8222
NPI assigned
May 31, 2018
Last updated
May 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Authorized official

Name
Nellie R Graham
Title
Credentialing Manager
Phone
(850) 577-0045

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X FL Primary

Addresses

Primary practice location

1210 Kemp Rd
Havana, FL 32333-1938

Mailing address

1210 Kemp Rd
Havana, FL 32333-1938
Phone (850) 539-8222

Other practice location 1

1210 Kemp Rd
Havana, FL 32333-1938
Phone (850) 539-8222

Other identifiers 1

IdentifierTypeStateIssuer
262263720MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
The Neighborhood Health8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

1210 Kemp Rd
Havana, FL 32333
Phone (850) 539-0065

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1093207607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 KEMP RD",
            "city": "HAVANA",
            "state": "FL",
            "postal_code": "323331938",
            "telephone_number": "850-539-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 KEMP RD",
            "city": "HAVANA",
            "state": "FL",
            "postal_code": "323331938",
            "telephone_number": "850-539-8222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1210 Kemp Rd",
            "address_purpose": "LOCATION",
            "city": "Havana",
            "state": "FL",
            "postal_code": "323331938",
            "country_code": "US",
            "telephone_number": "850-539-8222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEIGHBORHOOD MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "NELLIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "850-577-0045"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262263720",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Havana, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.