NPIMap

Organization Active NPI

North Florida Pediatrics PA

  • Pediatrics Physician
  • Chiefland, FL
National Provider Identifier
1235808668
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
NORTH FLORIDA PEDIATRICS PA
Practice address
2220 North Young Blvd
Chiefland, FL 32626
Phone
(352) 221-7337
Fax
(352) 221-7344
NPI assigned
Sep 9, 2021
Last updated
Sep 9, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH FLORIDA PEDIATRICS PA.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Authorized official

Name
Samuel SantelicesNPI 1669476552
Title
President/Ceo
Phone
(386) 758-0003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2220 North Young Blvd
Chiefland, FL 32626

Mailing address

1859 SW Newland Way
Lake City, FL 32025
Phone (386) 758-0003

Other identifiers 1

IdentifierTypeStateIssuer
101707000MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
North Florida Pediatrics PA18 organizations share this tax ID, including this one
Part of
North Florida Pediatrics PA

Other organizations with this tax ID 17

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

View all 17

Practitioners & affiliated clinicians

Practitioners 1

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": "1631145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631145600000",
    "number": "1235808668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1859 SW NEWLAND WAY",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "32025",
            "telephone_number": "386-758-0003",
            "fax_number": "386-755-4432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 NORTH YOUNG BLVD",
            "city": "CHIEFLAND",
            "state": "FL",
            "postal_code": "32626",
            "telephone_number": "352-221-7337",
            "fax_number": "352-221-7344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FLORIDA PEDIATRICS PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH FLORIDA PEDIATRICS PA.",
        "enumeration_date": "2021-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-08",
        "status": "A",
        "authorized_official_last_name": "SANTELICES",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "386-758-0003"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101707000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chiefland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.