MCR Health, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MCR HEALTH, INC.

Practice address

37220 Glenwood Ave
Myakka, FL 34251-0008

Phone

(941) 322-6500

Fax

(941) 322-2092

NPI assigned

Jun 30, 2006

Organization subpart

No

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

Authorized official

Name

Melvin B Price

Title

President and Ceo

Phone

(941) 776-4000

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709856000000",
    "number": "1124056759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RIVERFRONT BLVD STE 710",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058812",
            "telephone_number": "941-776-4000",
            "fax_number": "941-845-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37220 GLENWOOD AVE",
            "city": "MYAKKA",
            "state": "FL",
            "postal_code": "342510008",
            "telephone_number": "941-322-6500",
            "fax_number": "941-322-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCR HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2024-03-08",
        "certification_date": "2024-03-08",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "941-776-4000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029561206",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Ward Decou, A.R.N.P.

• All providers in Myakka, FL
• Federally Qualified Health Center (FQHC) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; 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.