NPIMap

Organization Active NPI

Trenton Medical Center, Inc.

Doing business as Palms Medical Group

  • Federally Qualified Health Center (FQHC)
  • Lake City, FL
National Provider Identifier
1124442355
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TRENTON MEDICAL CENTER, INC.
Doing business as
Palms Medical Group
Practice address
173 NW Albritton LN
Lake City, FL 32055-4451
Phone
(386) 755-4020
Fax
(386) 752-9143
NPI assigned
Feb 7, 2014
Last updated
Jan 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Authorized official

Name
Anita H. Rembert
Title
C.E.O.
Phone
(386) 454-0698

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X FL
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

173 NW Albritton LN
Lake City, FL 32055-4451

Mailing address

23476 NW 186TH Ave
High Springs, FL 32643-0673
Phone (386) 454-0698

Other identifiers 3

IdentifierTypeStateIssuer
029552300MedicaidFL
101867OtherFLMEDICARE NGS
97069OtherFLBCBSFL

Other names 1

  • Palms Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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…
O20140311000709 FL Part A Provider - Federally Qualified Health Center (FQHC) 2365359387 Practice locations: Lake City, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124442355. Details of each certification follow.

Federally qualified health center certification: CCN 101867

Legal name
TRENTON MEDICAL CENTER INC
Doing business as
PALMS MEDICAL GROUP
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – corporation
Most recent change of ownership
Feb 1, 2014 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Jan 14, 1988 in FL
Enrollment address
173 NW Albritton LN
Lake City, FL 32055-4451

Other NPIs with the same Medicare PAC ID 12

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

Other NPIs on the same Medicare enrollment 13

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

View all 13

National Provider Directory

National Provider Directory
Tax ID family
Trenton Medical Center16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

550 Georgia St
Starke, FL 32091
Phone (904) 364-2900

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stephen Elder Individual Corporate DirectorBoard Member Sep 20, 2018
Sarah Catalanotta Individual Corporate DirectorPresident Jan 1, 2015
Andrew Jones Individual Corporate DirectorCfo Oct 16, 2023
Gail M Osteen Individual Corporate DirectorBoard Member Feb 1, 2014
Anita Rembert Individual Corporate OfficerCeo Feb 28, 2010 100%
W-2 Managing EmployeeCeo Feb 1, 2014 100%
Charles E Hatch Individual Corporate DirectorSecretary Feb 1, 2014
Clifton E Bradley Individual Corporate DirectorVice President Feb 1, 2014
Julie Calvitt Individual Corporate Director Dec 7, 2023
Melissa Snodgrass Individual Corporate Director May 4, 2022
Marilyn T Thompson Individual Corporate DirectorBoard Member Feb 1, 2014
Linda D Walker Individual Corporate DirectorBoard Member Feb 1, 2014
Juan B Henley Individual Corporate DirectorTreasurer Feb 1, 2014

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Palms Medical GroupWilliston, FL, CCN 101031 Federally qualified health center Operational/Managerial Control (100%) Feb 27, 2014
Palms Medical GroupStarke, FL, CCN 101060 Federally qualified health center Operational/Managerial Control (100%) Feb 27, 2014
Palms Medical GroupGainesville, FL, CCN 101076 Federally qualified health center Operational/Managerial Control (100%) Feb 27, 2014
Palms Medical GroupChiefland, FL, CCN 101124 Federally qualified health center Operational/Managerial Control Feb 27, 2014
Palms Medical GroupLive Oak, FL, CCN 101158 Federally qualified health center Operational/Managerial Control (100%) Jul 1, 2014
Palms Medical Group, Family Healthcare Center of Columbia CountyHigh Springs, FL, CCN 101175 Federally qualified health center Operational/Managerial Control (100%) Feb 27, 2014
Palms Medical GroupLake City, FL, CCN 681168 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 10, 2020
Palms Medical GroupOrange Park, FL, CCN 101883 Federally qualified health center Operational/Managerial Control (100%) Oct 10, 2022
Palms Medical GroupFleming Island, FL, CCN 691196 Federally qualified health center Operational/Managerial Control Jul 24, 2023

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1391731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1124442355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23476 NW 186TH AVE",
            "city": "HIGH SPRINGS",
            "state": "FL",
            "postal_code": "326430673",
            "telephone_number": "386-454-0698",
            "fax_number": "386-454-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 NW ALBRITTON LN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554451",
            "telephone_number": "386-755-4020",
            "fax_number": "386-752-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRENTON MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-07",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "REMBERT",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "386-454-0698"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029552300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NGS",
            "identifier": "101867",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "97069",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palms Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Palms Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.