NPIMap

Organization Active NPI

District Clinic Holdings, Inc.

  • Federally Qualified Health Center (FQHC)
  • West Palm Beach, FL
National Provider Identifier
1164839841
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
DISTRICT CLINIC HOLDINGS, INC.
Practice address
3505 Shiloh Dr
West Palm Beach, FL 33407
Phone
(561) 242-5445
Fax
(561) 242-5447
NPI assigned
Jul 15, 2014
Last updated
Mar 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Authorized official

Name
Darcy J Davis
Title
Ceo
Phone
(561) 804-5885

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU

Addresses

Primary practice location

3505 Shiloh Dr
West Palm Beach, FL 33407

Mailing address

1515 N Flagler Dr Ste 101
West Palm Beach, FL 33401-3429
Phone (561) 659-1270

Other identifiers 2

IdentifierTypeStateIssuer
008037108MedicaidFL
008037109MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
District Clinic Holdings 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.

Locations

3505 Shiloh Dr
West Palm Beach, FL 33407
Phone (561) 242-5443

Practitioners & affiliated clinicians

Practitioners 1

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": "1405382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583712000000",
    "number": "1164839841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N FLAGLER DR STE 101",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013429",
            "telephone_number": "561-659-1270",
            "fax_number": "561-833-9469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 SHILOH DR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33407",
            "telephone_number": "561-242-5445",
            "fax_number": "561-242-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTRICT CLINIC HOLDINGS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-15",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DARCY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-804-5885"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008037108",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008037109",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; 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.