Trenton Medical Center, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Live Oak, FL
NPI 1124432042 · NPPES record last updated Jan 10, 2025
Key facts
- NPI
- 1124432042
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- TRENTON MEDICAL CENTER, INC.
- Practice address
- 211 Ranchera St NW
Live Oak, FL 32064 - Phone
- (386) 364-1751
- Fax
- (386) 364-1761
- NPI assigned
- Jun 18, 2014
- Organization subpart
- Yes
- Parent organization (as reported)
- TRENTON MEDICAL CENTER, INC.
Authorized official
- Name
- Mrs. Anita H Rembert
- Title
- C.E.O.
- Phone
- (386) 454-0698
Owners & managing parties with NPI records 12
Owned or controlled facilities with NPI records 8
Other NPIs on the same Medicare enrollment 13
Other NPIs with the same Medicare PAC ID 12
Facilities with the same owner 8
Practitioners 75
-
Sydney Graybill, PA-C
-
Carmen Anne Macdonald, APRN
-
Kristin Hope McIntosh, ARNP
-
Jessie L Peterson, APRN
-
David Rosales, PA-C
-
Lilia Del Mundo Acebron, ARNP
-
Jody Lynne Arnstein, APRN
-
Alexandra Baker, PA-C
-
Sharon Baldauf-Madero, PA-C
-
Matthew Barber, APRN
-
Payal Bhatt Abraham, M.D.
-
Chad Billington II, LMHC
-
Sheryl Burke, APRN
-
Risa Weletcka Clayton, APRN
-
Crystal Breeze Cullen, APRN
-
James Dawson, PA-C
-
Grace Dunn, M.D.
-
Haley Ford, PA-C
-
John D Frazier, D.C.
-
Sydney Griffith, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2082404 | Palms Medical Group | Provider-performed microscopy | Aug 12, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL
Federally qualified health center certification: CCN 101158
- Legal name
- TRENTON MEDICAL CENTER INC
- Doing business as
- PALMS MEDICAL GROUP
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jul 22, 2014
- Last certification
- Jul 22, 2014
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 14, 1988 in FL
- Enrollment address
- 211 Ranchera Street NW
Live Oak, FL 32064-8463
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Stephen Elder |
Corporate Director |
Sep 20, 2018 | |
| Sarah Catalanotta |
Corporate Director |
Aug 23, 1984 | |
| Andrew Jones |
Corporate Director |
Oct 16, 2023 | |
| Gail M Osteen |
Corporate Director |
Mar 31, 1988 | |
| Anita Rembert |
Corporate Officer |
Feb 28, 2010 | 100% |
| W-2 Managing Employee |
Feb 28, 2010 | 100% | |
| Operational/Managerial Control |
Feb 28, 2010 | 100% | |
| Trenton Medical Center Inc |
Operational/Managerial Control | Jul 1, 2014 | 100% |
| Charles E Hatch |
Corporate Director |
Nov 8, 2007 | |
| Clifton E Bradley |
Corporate Director |
Apr 7, 1988 | |
| Julie Calvitt |
Corporate Director | Dec 7, 2023 | |
| Melissa Snodgrass |
Corporate Director | May 4, 2022 | |
| Marilyn T Thompson |
Corporate Director |
Dec 31, 2010 | |
| Linda D Walker |
Corporate Director |
Dec 31, 2010 | |
| Juan B Henley |
Corporate Director |
Sep 13, 1994 |
All facility ownership & control disclosures 8
| Facility | Type | Role | Since |
|---|---|---|---|
| Palms Medical Group |
Federally qualified health center | Operational/Managerial Control (100%) | Feb 27, 2014 |
| Palms Medical Group |
Federally qualified health center | Operational/Managerial Control (100%) | Feb 27, 2014 |
| Palms Medical Group |
Federally qualified health center | Operational/Managerial Control (100%) | Feb 27, 2014 |
| Palms Medical Group |
Federally qualified health center | Operational/Managerial Control | Feb 27, 2014 |
| Palms Medical Group, Family Healthcare Center of Columbia County |
Federally qualified health center | Operational/Managerial Control (100%) | Feb 27, 2014 |
| Palms Medical Group |
Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Jan 10, 2020 |
| Palms Medical Group |
Federally qualified health center | Operational/Managerial Control (100%) | Oct 10, 2022 |
| Palms Medical Group |
Federally qualified health center | Operational/Managerial Control | Jul 24, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050428000865 | FL | Part B Supplier - Clinic/Group Practice | 2365359387 |
Receives reassigned benefits from 129 practitioners 13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lake City, FL; Williston, FL; Trenton, FL; Starke, FL; Orange Park, FL; Live Oak, FL; High Springs, FL; Gainesville, FL… |
| O20140722001647 | FL | Part a Provider - Federally Qualified Health Center (FQHC) | 2365359387 | Practice locations: Live Oak, FL |
National Provider Directory
- Part of
- Trenton Medical Center Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
211 Ranchera St NW
Live Oak, FL 32064
Mailing address
23476 NW 186TH Ave
High Springs, FL 32643-0673
Phone (386) 454-0698
Other names
- Palms Medical Group
Other providers in Live Oak, FL
- Cameron Tolar
- Tiffany Topping
- Christina Joy Townsend
- Transcare Services, Inc.
- Trenton Medical Center, Inc.
- Trenton Medical Center, Inc.
- Trieu Foot Solutions LLC
- Twin Rivers Mental Health
- Doreen Vargas
- Tovah O Vargas
All providers in Live Oak, FL · Federally Qualified Health Center (FQHC) in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.