Organization Active NPI

Choices Health Center, Inc.

Doing business as Choices Health Center

  • Clinic/Center
  • Orange City, FL
National Provider Identifier
1235369182
Registry record updated Jul 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
HCC7157 Issued in FL
Legal business name
CHOICES HEALTH CENTER, INC.
Doing business as
Choices Health Center
Practice address
747 Fawn Ridge Dr
Suite 100
Orange City, FL 32763-8268
Phone
(386) 456-1047
Fax
(866) 707-3476
NPI assigned
Jul 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2013

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

Authorized official

Name
Mr. Shane E Wilson
Title
Coo
Phone
(386) 456-1047

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X HCC7157 FL Primary

Addresses

Primary practice location

747 Fawn Ridge Dr
Suite 100
Orange City, FL 32763-8268

Mailing address

747 Fawn Ridge Dr
Suite 100
Orange City, FL 32763-8268
Phone (386) 456-1047

Other identifiers 1

IdentifierTypeStateIssuer
004619500MedicaidFL

Other names 1

  • Choices Health Center Doing business as

National Provider Directory

National Provider Directory

Locations

2751 Enterprise Rd
Ste 110
Orange City, FL 32763
Phone (386) 456-1047

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2312/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1235369182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 FAWN RIDGE DR",
            "address_2": "SUITE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638268",
            "telephone_number": "386-456-1047",
            "fax_number": "866-707-3476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 FAWN RIDGE DR",
            "address_2": "SUITE 100",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638268",
            "telephone_number": "386-456-1047",
            "fax_number": "866-707-3476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOICES HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-24",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SHANE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "386-456-1047",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "HCC7157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004619500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Choices Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.