HN Ucc LLC
Organization Active NPI Urgent Care Clinic/Center · Daytona Beach, FL
NPI 1093308504 · NPPES record last updated Apr 10, 2024
Key facts
- NPI
- 1093308504
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- HN UCC LLC
- Practice address
- 3048 S Atlantic Ave
Daytona Beach, FL 32118-6102 - Phone
- (423) 531-1330
- NPI assigned
- Feb 16, 2021
- Organization subpart
- No
Authorized official
- Name
- Katherine Elizabeth Pendergrass
- Title
- Director of Revenue Cycle
- Phone
- (423) 331-2055
Practitioners 26
-
Danielle Lee Cook, ARNP
-
Jessica Crowell, APRN
-
Jody Michele King, ARNP, FNP-C
-
Lindsey Ann Londono, APRN
-
Teresa Lorenzo, ARNP
-
Jane Dumont McMillan, APRN
-
Holly Slatinsky, ARNP
-
Julie Bom Conselho, ARNP
-
Amber Jo Bryant, ARNP
-
Julio C Casas, M.D.
-
Hung Doan, MD
-
Regina M George, NP
-
Jessica Lea Hayes, ARNP
-
Jessica Dawn Huckaby, ARNP
-
Sarah Lower, ARNP
-
Vanessa Odriozola, FNP-BC
-
Vickie Lynn Sorrell, FNP-BC
-
David M. Alvarez, MD
-
Michael P Smith, APRN-CNP
-
Ines Taylor, ARNP/FNP
-
Christian Atkins, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2230698 | HN Ucc LLC D/a Halifax Health Express Care | Certificate of waiver | Jul 26, 2027 |
| 10D2231985 | HN Ucc LLC D/a Halifax Health Express Care | Certificate of waiver | Aug 8, 2027 |
| 10D2241382 | HN Ucc LLC D/a Halifax Health Expresscare | Certificate of waiver | Oct 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210831002196 | FL | Part B Supplier - Clinic/Group Practice | 8426454489 |
Receives reassigned benefits from 25 practitioners Practice locations: Daytona Beach, FL; Deltona, FL; Ormond Beach, FL; Port Orange, FL |
National Provider Directory
Locations
3048 S Atlantic Ave
Daytona Beach Shores, FL 32118
Phone (386) 457-8758
2090 Saxon Blvd
Deltona, FL 32725
Phone (386) 845-5452
1688 W Granada Blvd
Ste 1C
Ormond Beach, FL 32174
Phone (386) 845-5453
775 W Granada Blvd
Ste 102
Ormond Beach, FL 32174
Phone (386) 425-4480
5440 S Williamson Blvd
Port Orange, FL 32128
Phone (386) 845-5451
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
3048 S Atlantic Ave
Daytona Beach, FL 32118-6102
Mailing address
3048 S Atlantic Ave
Daytona Beach, FL 32118-6102
Other practice location 1
5440 S Williamson Blvd
Port Orange, FL 32128
Phone (423) 531-1330
Other practice location 2
2090 Saxon Blvd
Deltona, FL 32725-3251
Phone (423) 531-1330
Other practice location 3
1688 W Granada Blvd Ste 1C
Ormond Beach, FL 32174-1818
Phone (423) 531-1330
Other names
- Halifax Health Express Care
Other providers in Daytona Beach, FL
- Sally Kathleen Hinman
- Charlotte F. Hinson
- Susan Hinson
- Cindy May Hird
- James K Hitchman
- Mary Ann Hocker
- Jonathan David Hodge
- Monica A Hodge
- Trevon Hodge
- Louvina Hodges-Flowers
All providers in Daytona Beach, FL · Urgent Care Clinic/Center in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.