NPIMap

Organization Active NPI

Young Men's Christian Association of the Suncoast, Inc.

  • Health Educator
  • Palm Harbor, FL
National Provider Identifier
1194272518
Registry record updated Sep 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Legal business name
YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE SUNCOAST, INC.
Practice address
4550 Village Center Dr
Palm Harbor, FL 34685-1224
Phone
(727) 772-9622
Fax
(727) 785-1806
NPI assigned
Sep 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2016

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

Authorized official

Name
Mr. G. Scott Goyer
Title
President and Ceo
Phone
(727) 467-9622

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health EducatorGroup: 193200000X MULTI-SPECIALTY GROUP 174H00000X Primary

Addresses

Primary practice location

4550 Village Center Dr
Palm Harbor, FL 34685-1224

Mailing address

2469 Enterprise Rd
Clearwater, FL 33763-1702
Phone (727) 467-9622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180809005278 FL MDPP Supplier - in-Person MDPP Supplier 3375891195 Practice locations: Trinity, FL; Spring Hill, FL; Palm Harbor, FL; New Port Richey, FL; Largo, FL; Dunedin, FL; Clearwater, FL; Lecanto, FL

National Provider Directory

National Provider Directory

Locations

2469 Enterprise Rd
Clearwater, FL 33763
Phone (727) 459-5618

4550 Village Center Dr
Palm Harbor, FL 34685
Phone (727) 772-9622

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1194272518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2469 ENTERPRISE RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631702",
            "telephone_number": "727-467-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 VILLAGE CENTER DR",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346851224",
            "telephone_number": "727-772-9622",
            "fax_number": "727-785-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE SUNCOAST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "GOYER",
        "authorized_official_first_name": "G.",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "727-467-9622",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.