NPIMap

Organization Active NPI

Emmanuel Health Care Inc

  • Family Medicine Physician
  • Deland, FL
National Provider Identifier
1134518616
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME79609 Issued in FL
Legal business name
EMMANUEL HEALTH CARE INC
Practice address
909 N Stone St
Deland, FL 32720-2521
Phone
(386) 279-7726
Fax
(386) 873-2927
NPI assigned
Jan 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Authorized official

Name
Ian Wood
Title
Owner
Phone
(386) 279-7726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME79609 FL Primary

Addresses

Primary practice location

909 N Stone St
Deland, FL 32720-2521

Mailing address

909 N Stone St
Deland, FL 32720-2521
Phone (386) 279-7726

Other identifiers 1

IdentifierTypeStateIssuer
ME79609OtherFLMEDICAL LICENSE

National Provider Directory

National Provider Directory

Locations

909 N Stone St
Deland, FL 32720
Phone (386) 279-7726

NPI Registry JSON

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1134518616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202521",
            "telephone_number": "386-279-7726",
            "fax_number": "386-873-2927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 N STONE ST",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327202521",
            "telephone_number": "386-279-7726",
            "fax_number": "386-873-2927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMANUEL HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-21",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-279-7726"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME79609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME79609",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; 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.