Organization Active NPI

Allergy Specialty Care PA

  • Specialist
  • Lake City, FL
National Provider Identifier
1104141118
Registry record updated Apr 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PA2020 Issued in FL
Legal business name
ALLERGY SPECIALTY CARE PA
Practice address
213 SW Main Blvd
Lake City, FL 32025-7001
Phone
(386) 961-9809
Fax
(386) 961-8311
NPI assigned
Apr 1, 2010
Last updated
Apr 1, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2010

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

Authorized official

Name
Mrs. Denise Cone
Title
Insurance Billing Manager
Phone
(386) 961-9809

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X PA2020 FL Primary

Addresses

Primary practice location

213 SW Main Blvd
Lake City, FL 32025-7001

Mailing address

213 SW Main Blvd
Lake City, FL 32025-7001
Phone (386) 961-9809

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100916000426 FL Part B Supplier - Clinic/Group Practice 1759406747 Receives reassigned benefits from 4 practitioners
Practice locations: Lake City, FL

National Provider Directory

National Provider Directory

Locations

213 SW Main Blvd
Lake City, FL 32025
Phone (386) 961-9809

213 SW Main Blvd
Ste 1
Lake City, FL 32025

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270080000000",
    "number": "1104141118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320257001",
            "telephone_number": "386-961-9809",
            "fax_number": "386-961-8311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 SW MAIN BLVD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320257001",
            "telephone_number": "386-961-9809",
            "fax_number": "386-961-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY SPECIALTY CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-01",
        "last_updated": "2010-04-01",
        "status": "A",
        "authorized_official_last_name": "CONE",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "INSURANCE BILLING MANAGER",
        "authorized_official_telephone_number": "386-961-9809",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "PA2020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2010; 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.