NPIMap

Organization Active NPI

Tallahassee Memorial Healthcare Inc

Doing business as Tallahassee Memorial Diabetes Center

  • Clinic/Center
  • Tallahassee, FL
National Provider Identifier
1114976974
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
TALLAHASSEE MEMORIAL HEALTHCARE INC
Doing business as
Tallahassee Memorial Diabetes Center
Practice address
2633 Centennial Blvd Ste 100
Tallahassee, FL 32308-0606
Phone
(850) 431-5404
Fax
(850) 656-3376
NPI assigned
May 9, 2006
Last updated
Jan 9, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
TALLAHASSEE MEMORIAL HEALTHCARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Authorized official

Name
Mrs. Jennifer Parks
Title
President
Phone
(850) 431-6234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X FL Primary

Addresses

Primary practice location

2633 Centennial Blvd Ste 100
Tallahassee, FL 32308-0606

Mailing address

1607 Saint James CT Ste 1
Tallahassee, FL 32308-5352
Phone (850) 431-7021

Other identifiers 2

IdentifierTypeStateIssuer
010113300MedicaidFL
406OtherFLBCBS GROUP #

Other names 1

  • Tallahassee Memorial Diabetes Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Tallahassee Memorial Em38 organizations share this tax ID, including this one
Part of
Tallahassee Memorial Em

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1114976974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 SAINT JAMES CT STE 1",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085352",
            "telephone_number": "850-431-7021",
            "fax_number": "850-431-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 CENTENNIAL BLVD STE 100",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080606",
            "telephone_number": "850-431-5404",
            "fax_number": "850-656-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TALLAHASSEE MEMORIAL HEALTHCARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TALLAHASSEE MEMORIAL HEALTHCARE INC",
        "enumeration_date": "2006-05-09",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-431-6234",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010113300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "406",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tallahassee Memorial Diabetes Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tallahassee Memorial Diabetes Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; 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.