Three Oaks Family Medicine LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

THREE OAKS FAMILY MEDICINE LLC

Practice address

825 E Cowboy Way
Units 102/103
Labelle, FL 33935

Phone

(239) 560-2657

NPI assigned

Aug 17, 2020

Organization subpart

No

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

Authorized official

Name

Amanda Pacheco, ARNP-CNPI 1659800662

Title

Owner/Provider

Phone

(239) 560-2657

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

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

• Amanda Michelle Pacheco, ARNP FNP-C

  • Family Nurse Practitioner
  • Clewiston, FL
  • NPI 1659800662
  Medicare reassignment Care Compare group Authorized official
• Tiffany Ballentine

  • Family Nurse Practitioner
  • Fort Myers, FL
  • NPI 1558010694
  Medicare reassignment Care Compare group NPD
• Janet Dominguez-Giron, ARNP

  • Family Nurse Practitioner
  • Labelle, FL
  • NPI 1528511557
  Medicare reassignment Care Compare group NPD
• Valaree Alexis Luck, DO

  • Family Medicine Physician
  • Labelle, FL
  • NPI 1225454614
  Medicare reassignment Care Compare group NPD
• Abigail Diana Perez

  • Family Nurse Practitioner
  • Labelle, FL
  • NPI 1922958693
  Medicare reassignment Care Compare group NPD
• Kindall Tindall Ward, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Labelle, FL
  • NPI 1720630098
  Medicare reassignment Care Compare group NPD
• Sarah Jean Von Frantzius, APRN

  • Nurse Practitioner
  • Cape Coral, FL
  • NPI 1669093902
  Medicare reassignment NPD
• Jamie L Benigno, APRN, FNP-BC

  • Nurse Practitioner
  • Port Charlotte, FL
  • NPI 1689354433
  Care Compare group

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597622400000",
    "number": "1194336701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 VIA DEL AQUA",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334402422",
            "telephone_number": "239-560-2657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E COWBOY WAY",
            "address_2": "UNITS 102/103",
            "city": "LABELLE",
            "state": "FL",
            "postal_code": "33935",
            "telephone_number": "239-560-2657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE OAKS FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A",
        "authorized_official_last_name": "PACHECO",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "239-560-2657",
        "authorized_official_credential": "ARNP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Labelle, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.