Columbia Family Medicine

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

COLUMBIA FAMILY MEDICINE

Practice address

238 SW Cullen Ave
Fort White, FL 32038-3536

Phone

(386) 497-1397

NPI assigned

Oct 31, 2022

Organization subpart

No

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

Authorized official

Name

David Wayne Davis

Title

Owner

Phone

(386) 365-0809

Specialties & licenses 1

Addresses

Other names 1

• Columbia Family Medicine Doing business as

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1104533173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 SW CULLEN AVE",
            "city": "FORT WHITE",
            "state": "FL",
            "postal_code": "320383536",
            "telephone_number": "386-365-0809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 SW CULLEN AVE",
            "city": "FORT WHITE",
            "state": "FL",
            "postal_code": "320383536",
            "telephone_number": "386-497-1397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-365-0809"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Columbia Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joanna M Bagg, M.A.
• Cathi N Brown, MOT, OTR/L
• Care Station, LLC
• Caring Wheels Transportation LLC
• Sarah Louise Clark
• Felisa Ann Davis-Holmes
• David Wayne Davis
• Ft. White Alf BSLC LLC
• Lee L Gibson, D.O.
• Grace Pediatrics PL

• All providers in Fort White, FL
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.