Active NPI
Choices Health Center, Inc.
Doing business as Choices Health Center
- Clinic/Center
- Orange City, FL
National Provider Identifier
1235369182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- License
- HCC7157
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004619500 | Medicaid | FL |
Other names 1
- Choices Health Center
National Provider Directory
National Provider DirectoryLocations
2751 Enterprise Rd
Ste 110
Orange City, FL 32763
Phone (386) 456-1047
Interoperability endpoints
- 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.