NPIMap

Organization Active NPI

Primary Care Medical Services of Poinciana, Inc.

Doing business as Mobile Dental Care #2

  • Federally Qualified Health Center (FQHC)
  • Kissimmee, FL
National Provider Identifier
1164282679
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PRIMARY CARE MEDICAL SERVICES OF POINCIANA, INC.
Doing business as
Mobile Dental Care #2
Practice address
1875 Fortune Rd
Kissimmee, FL 34744-4428
Phone
(407) 943-8600
NPI assigned
Mar 21, 2024
Last updated
Jan 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Authorized official

Name
Dr. Belinda Johnson-Cornett
Title
Ceo
Phone
(407) 414-9760

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1875 Fortune Rd
Kissimmee, FL 34744-4428

Mailing address

1503 Bill Beck Blvd
Kissimmee, FL 34744-9516
Phone (407) 943-8600

Other names 1

  • Mobile Dental Care #2 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Primary Care Medical Services of Poinciana Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738022400000",
    "number": "1164282679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 BILL BECK BLVD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347449516",
            "telephone_number": "407-943-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 FORTUNE RD",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347444428",
            "telephone_number": "407-943-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE MEDICAL SERVICES OF POINCIANA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-21",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON-CORNETT",
        "authorized_official_first_name": "BELINDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-414-9760",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobile Dental Care #2",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mobile Dental Care #2",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.