NPIMap

Organization Active NPI

Volusia Hospitalists PLC

  • Internal Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1104864727
Registry record updated Aug 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
VOLUSIA HOSPITALISTS PLC
Practice address
301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167
Phone
(386) 676-0255
Fax
(386) 676-2555
NPI assigned
Jun 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2023

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

Authorized official

Name
Amanda Brooke Davis
Title
Administrator
Phone
(386) 676-0255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

301 Memorial Medical Pkwy
Daytona Beach, FL 32117-5167

Mailing address

PO Box 282004
Tampa, FL 33630-2004
Phone (386) 676-0255

Other identifiers 14

IdentifierTypeStateIssuer
276566700MedicaidFL
35736OtherFLBLUE CROSS BLUE SHIELD
94174OtherFLBLUE CROSS BLUE SHIELD
94426OtherFLBLUE CROSS BLUE SHIELD
2774554200MedicaidFL
262576800MedicaidFL
254097500MedicaidFL
32081OtherFLBLUE CROSS BLUE SHIELD
007101800MedicaidFL
009807600MedicaidFL
14T2LOtherFLBLUE CROSS BLUE SHIELD
250751000MedicaidFL
276082700MedicaidFL
42358OtherFLBLUE CROSS BLUE SHIELD

Other names 2

  • Volusia Hospitalist PLC Doing business as
  • Volusia Hospitalists PLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060907000179 FL Part B Supplier - Clinic/Group Practice 0345253860 Receives reassigned benefits from 16 practitioners
Practice locations: Daytona Beach, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692316800000",
    "number": "1104864727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 282004",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336302004",
            "telephone_number": "386-676-0255",
            "fax_number": "386-676-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MEMORIAL MEDICAL PKWY",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175167",
            "telephone_number": "386-676-0255",
            "fax_number": "386-676-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VOLUSIA HOSPITALISTS PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2023-08-18",
        "certification_date": "2023-08-18",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "BROOKE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "386-676-0255"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276566700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "35736",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "94174",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "94426",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2774554200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "262576800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254097500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "32081",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007101800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009807600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "14T2L",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250751000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276082700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "42358",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Volusia Hospitalist PLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Volusia Hospitalist PLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Volusia Hospitalists PLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; 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.