NPIMap

Organization Active NPI

Acts Signature Community Services, Inc.

Doing business as Primary Care Services at Azalea Trace

  • Internal Medicine Physician
  • Pensacola, FL
National Provider Identifier
1215326335
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ACTS SIGNATURE COMMUNITY SERVICES, INC.
Doing business as
Primary Care Services at Azalea Trace
Practice address
10100 Hillview Drive
Pensacola, FL 32514
Phone
(850) 478-5200
Fax
(850) 474-0558
NPI assigned
Jan 13, 2015
Last updated
Feb 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Authorized official

Name
Susan Ahern
Title
SVP, Cfo
Phone
(215) 661-8330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

10100 Hillview Drive
Pensacola, FL 32514

Mailing address

420 Delaware Dr
Fort Washington, PA 19034-2711
Phone (267) 787-4097

Other names 1

  • Primary Care Services at Azalea Trace Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, DE3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20150723007891 FL Part B Supplier - Clinic/Group Practice 1951212380 Receives reassigned benefits from 7 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Boca Raton, FL; Pensacola, FL; Vero Beach, FL
O20160502002366 DE Part B Supplier - Clinic/Group Practice 5092032284 Receives reassigned benefits from 6 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hockessin, DE; Seaford, DE; Wilmington, DE
O20160512001716 FL Part B Supplier - Clinic/Group Practice 5092032284 Receives reassigned benefits from 12 practitioners
3 other NPIs on this enrollment
Practice locations: Boca Raton, FL; Pensacola, FL; Vero Beach, FL

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Acts Sig Comm Srvcs28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All facility ownership & control disclosures 25

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Willowbrooke Court Skilled Care Center at Fort Washington EstatesFort Washington, PA, CCN 395496 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court at Indian River EstatesVero Beach, FL, CCN 105593 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court SC Ctr at Matthews GlenMatthews, NC, CCN 345326 Skilled nursing facility Indirect Ownership Interest Mar 24, 2009
Willowbrooke Court Skilled Care Center-Edgewater at Boca PointeBoca Raton, FL, CCN 105489 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court at St. Andrews EstatesBoca Raton, FL, CCN 105355 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court at Southampton EstatesSouthampton, PA, CCN 395490 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court at Granite Farms EstatesMedia, PA, CCN 395736 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court SC Center at Tryon EstatesColumbus, NC, CCN 345459 Skilled nursing facility Indirect Ownership Interest Mar 24, 2009
Willowbrooke Court Skilled Care Center at Normandy Farms EstatesBlue Bell, PA, CCN 395665 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court Skilled Care Center at Lima EstatesLima, PA, CCN 395492 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court at Spring House EstatesLower Gwynedd, PA, CCN 395495 Skilled nursing facility Indirect Ownership Interest Mar 24, 2009
Willowbrooke Court Skilled Care Center at Brittany Pointe EstatesLansdale, PA, CCN 395762A Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court at Lanier Village EstatesGainesville, GA, CCN 115687 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court at Azalea TracePensacola, FL, CCN 105444 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
The Cedar at Mease LifeDunedin, FL, CCN 105732 Skilled nursing facility Indirect Ownership Interest Oct 1, 2023
Willowbrooke Court Skilled Care Center at the TerracesBonita Springs, FL, CCN 106104 Skilled nursing facility Indirect Ownership Interest Nov 1, 2024
Willowbrooke Court Skilled Care Center at Magnolia TraceHuntsville, AL, CCN 015450 Skilled nursing facility Indirect Ownership Interest Mar 24, 2009
Willowbrooke Court at Cokesbury VillageHockessin, DE, CCN 085017 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court at Country HouseWilmington, DE, CCN 085003 Skilled nursing facility Indirect Ownership Interest Mar 24, 2009
Willowbrooke Court at Manor HouseSeaford, DE, CCN 085009 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court Skilled Care Center at FairhavenSykesville, MD, CCN 215130 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court Skilled Care Center at Buckingham's ChoiceAdamstown, MD, CCN 215329 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court Skilled Care Center at Bayleigh ChaseEaston, MD, CCN 215137 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court Skilled Care at EvergreensMoorestown, NJ, CCN 315077 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022
Willowbrooke Court Skilled Care Center at Heron PointChestertown, MD, CCN 215235 Skilled nursing facility Indirect Ownership Interest Dec 31, 2022

Owned or controlled facilities with NPI records 25

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 25

Practitioners & affiliated clinicians

Practitioners 12

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": "1421107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1215326335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE DR",
            "city": "FORT WASHINGTON",
            "state": "PA",
            "postal_code": "190342711",
            "telephone_number": "267-787-4097",
            "fax_number": "215-699-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 HILLVIEW DRIVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32514",
            "telephone_number": "850-478-5200",
            "fax_number": "850-474-0558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTS SIGNATURE COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-13",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "AHERN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "SVP, CFO",
        "authorized_official_telephone_number": "215-661-8330"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Care Services at Azalea Trace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.