Dr Ejaz Ahmed MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME95557 Issued in FL

Legal business name

DR EJAZ AHMED MD PA

Doing business as

Urgent Care & Family Practice Center

Practice address

405 North Clyde Morris Blvd
Daytona Beach, FL 32114-2730

Phone

(386) 235-8731

Fax

(386) 269-9555

NPI assigned

Nov 6, 2014

Last updated

Nov 6, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ejaz Ahmed, MDNPI 1003841081

Title

President

Phone

(386) 235-8731

Specialties & licenses 1

Addresses

Other names 1

• URGENT CARE & FAMILY PRACTICE CENTER Doing business as

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

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.

• Ejaz Ahmed, MD

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1003841081
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1245636042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3848 CALLIOPE AVE",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296025",
            "telephone_number": "386-235-8731",
            "fax_number": "386-269-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 NORTH CLYDE MORRIS BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142730",
            "telephone_number": "386-235-8731",
            "fax_number": "386-269-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR EJAZ AHMED MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "EJAZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-235-8731",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME95557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "URGENT CARE & FAMILY PRACTICE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William P Douglass, MD
• Lisa Marlene Douthwaite, ARNP
• Debra Dowell, APRN
• Chaconna Downs, LCSW
• Cherise Jenelle Doyley, DOULA
• Dr John P Christensen P a
• Dr Sutinder S Kohli PA
• Dr. Christina L Sajgo DC LLC
• Dr. Joe E.Miller II Optometrist PA
• Betty Ann Drane, RN

• Family Medicine Physician in Daytona Beach, FL
• Providers in Daytona Beach, 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 Nov 6, 2014; 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.