Fort Pierce Intermediate Care Center

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

FORT PIERCE INTERMEDIATE CARE CENTER

Doing business as

Fort Pierce Walk-In Medical Clinic

Practice address

900 Virginia Ave
Suite 10
Fort Pierce, FL 34982-5882

Phone

(772) 464-6551

Fax

(772) 465-0322

NPI assigned

Mar 2, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Craig Walker

Title

VP

Phone

(800) 661-3365

Specialties & licenses 1

Addresses

Other names 1

• Fort Pierce Walk-In Medical Clinic Doing business as

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184753758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 VIRGINIA AVE",
            "address_2": "SUITE 10",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349825882",
            "telephone_number": "772-464-6551",
            "fax_number": "772-465-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 VIRGINIA AVE",
            "address_2": "SUITE 10",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349825882",
            "telephone_number": "772-464-6551",
            "fax_number": "772-465-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT PIERCE INTERMEDIATE CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "800-661-3365"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fort Pierce Walk-In Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Ross Foncham Bradley, ARNP
• Forever Loving Hands, Inc
• Fort Pierce Discount Pharmacy, Inc.
• Fort Pierce Family Care, Inc.
• Fort Pierce Health Care Associates LLC (Fort Pierce Health Care)
• Fort Pierce Orthopaedics LLC
• Fort Pierce Vision LLC
• Tisa D Forte, RN
• Eddrekcia Foster
• Elizabeth Fowler

• General Practice Physician in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.