NPIMap

Organization Active NPI

Trenton Medical Center Inc

Doing business as Palms Medical Group

  • Federally Qualified Health Center (FQHC)
  • Williston, FL
National Provider Identifier
1255577631
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
TRENTON MEDICAL CENTER INC
Doing business as
Palms Medical Group
Practice address
630 N Main St
Williston, FL 32696-1705
Phone
(352) 528-0587
Fax
(352) 528-4834
NPI assigned
Jan 6, 2009
Last updated
Jan 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Authorized official

Name
Anita H. Rembert
Title
Ceo
Phone
(386) 454-0698

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

630 N Main St
Williston, FL 32696-1705

Mailing address

23476 NW 186TH Ave
High Springs, FL 32643-0673
Phone (386) 454-0698

Other identifiers 1

IdentifierTypeStateIssuer
029506011MedicaidFL

Other names 1

  • Palms Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050428000865 FL Part B Supplier - Clinic/Group Practice 2365359387 Receives reassigned benefits from 129 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lake City, FL; Williston, FL; Trenton, FL; Starke, FL; Orange Park, FL; Live Oak, FL; High Springs, FL; Gainesville, FL…
O20090826000844 FL Part A Provider - Federally Qualified Health Center (FQHC) 2365359387 Practice locations: Williston, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255577631. Details of each certification follow.

Federally qualified health center certification: CCN 101031

Legal name
TRENTON MEDICAL CENTER INC
Doing business as
PALMS MEDICAL GROUP
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 29, 2009
Last certification
Jan 29, 2009
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 14, 1988 in FL
Enrollment address
630 N. Main Street
Williston, FL 32696-1705

Other NPIs with the same Medicare PAC ID 12

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

Other NPIs on the same Medicare enrollment 13

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

View all 13

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1096050Trenton Medical Center Inc Dba Palms Medical Group630 N Main St, Williston, FL 32696Provider-performed microscopyFeb 23, 2027

National Provider Directory

National Provider Directory

Locations

1830 N Main St
Bell, FL 32619
Phone (352) 463-1100

103 US Highway 27 SW
Branford, FL 32008
Phone (386) 395-3090

2349 Village Square Pkwy
Ste 110111
Fleming Island, FL 32003
Phone (904) 385-2023

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Stephen Elder Individual Corporate DirectorDirector Sep 20, 2018
Sarah Catalanotta Individual Corporate DirectorPresident Aug 23, 1984
Andrew Jones Individual Corporate DirectorCfo Oct 16, 2023
Gail M Osteen Individual Corporate DirectorDirector Aug 23, 1984
Anita Rembert Individual Corporate DirectorCeo Sep 1, 2010 100%
W-2 Managing EmployeeCeo Sep 1, 2010 100%
Trenton Medical Center Inc Organization, Trenton, FL Non-profit Operational/Managerial Control Feb 27, 2014 100%
Charles E Hatch Individual Corporate DirectorSecretary Nov 8, 2007
Clifton E Bradley Individual Corporate DirectorVice President Apr 7, 1988
Julie Calvitt Individual Corporate Director Dec 7, 2023
Melissa Snodgrass Individual Corporate Director May 4, 2022
Marilyn T Thompson Individual Corporate DirectorDirector Jan 29, 2009
Linda D Walker Individual Corporate DirectorDirector Jan 29, 2009
Juan B Henley Individual Corporate DirectorTreasurer Sep 13, 1994

Owners & managing parties with NPI records 12

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 8

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

FacilityTypeRoleSince
Palms Medical GroupStarke, FL, CCN 101060 Federally qualified health center Operational/Managerial Control (100%) Feb 27, 2014
Palms Medical GroupGainesville, FL, CCN 101076 Federally qualified health center Operational/Managerial Control (100%) Feb 27, 2014
Palms Medical GroupChiefland, FL, CCN 101124 Federally qualified health center Operational/Managerial Control Feb 27, 2014
Palms Medical GroupLive Oak, FL, CCN 101158 Federally qualified health center Operational/Managerial Control (100%) Jul 1, 2014
Palms Medical Group, Family Healthcare Center of Columbia CountyHigh Springs, FL, CCN 101175 Federally qualified health center Operational/Managerial Control (100%) Feb 27, 2014
Palms Medical GroupLake City, FL, CCN 681168 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Jan 10, 2020
Palms Medical GroupOrange Park, FL, CCN 101883 Federally qualified health center Operational/Managerial Control (100%) Oct 10, 2022
Palms Medical GroupFleming Island, FL, CCN 691196 Federally qualified health center Operational/Managerial Control Jul 24, 2023

Owned or controlled facilities with NPI records 8

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

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1255577631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23476 NW 186TH AVE",
            "city": "HIGH SPRINGS",
            "state": "FL",
            "postal_code": "326430673",
            "telephone_number": "386-454-0698",
            "fax_number": "386-454-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 N MAIN ST",
            "city": "WILLISTON",
            "state": "FL",
            "postal_code": "326961705",
            "telephone_number": "352-528-0587",
            "fax_number": "352-528-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRENTON MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-06",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "REMBERT",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "386-454-0698"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029506011",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palms Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Palms Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Williston, FL

Sources for this page

Verify at the official NPI Registry.