NPIMap

Organization Active NPI

Sumter Pediatrics PA

  • Primary Care Clinic/Center
  • Sumterville, FL
National Provider Identifier
1265005565
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SUMTER PEDIATRICS PA
Practice address
617 S US 301 Ste B
Sumterville, FL 33585-5355
Phone
(352) 569-4980
NPI assigned
Jul 23, 2021
Last updated
Jul 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Authorized official

Name
Mohammad AfzalNPI 1669411161
Title
Owner
Phone
(352) 394-3929

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

617 S US 301 Ste B
Sumterville, FL 33585-5355

Mailing address

617 S US 301 Ste B
Sumterville, FL 33585-5355
Phone (352) 569-4980

Other identifiers 1

IdentifierTypeStateIssuer
014683501MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Sumter Pediatrics PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

617 S US 301
Ste B
Sumterville, FL 33585
Phone (352) 569-4980

Practitioners & affiliated clinicians

Practitioners 3

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": "1626998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1265005565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 S US 301 STE B",
            "city": "SUMTERVILLE",
            "state": "FL",
            "postal_code": "335855355",
            "telephone_number": "352-569-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 S US 301 STE B",
            "city": "SUMTERVILLE",
            "state": "FL",
            "postal_code": "335855355",
            "telephone_number": "352-569-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMTER PEDIATRICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "AFZAL",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-394-3929"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014683501",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sumterville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.