NPIMap

Organization Active NPI

Medical Technology Transfer Corporation

Doing business as Harris Family Medical Center

  • Primary Care Clinic/Center
  • Melbourne, FL
National Provider Identifier
1104947217
Registry record updated Aug 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MEDICAL TECHNOLOGY TRANSFER CORPORATION
Doing business as
Harris Family Medical Center
Practice address
1800 W Hibiscus Blvd Ste 101
Melbourne, FL 32901-2624
Phone
(321) 726-1600
Fax
(321) 726-1610
NPI assigned
Apr 3, 2007
Last updated
Aug 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2008

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

Authorized official

Name
Mrs. Lynn Sprunger, RN
Title
Director of Operations
Phone
(321) 726-1609

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1800 W Hibiscus Blvd Ste 101
Melbourne, FL 32901-2624

Mailing address

1800 W Hibiscus Blvd Ste 101
Melbourne, FL 32901-2624
Phone (321) 726-1600

Other names 1

  • Harris Family Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209000360 FL Part B Supplier - Clinic/Group Practice 1658265079 Receives reassigned benefits from 81 practitioners
3 other NPIs on this enrollment
Practice locations: Fort Myers, FL; Melbourne, FL; Parrish, FL; West Palm Beach, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 82

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.

View all 82

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219622400000",
    "number": "1104947217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 W HIBISCUS BLVD STE 101",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012624",
            "telephone_number": "321-726-1600",
            "fax_number": "321-726-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 W HIBISCUS BLVD STE 101",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012624",
            "telephone_number": "321-726-1600",
            "fax_number": "321-726-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL TECHNOLOGY TRANSFER CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-08-25",
        "status": "A",
        "authorized_official_last_name": "SPRUNGER",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "321-726-1609",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harris Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; 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.