NPIMap

Organization Active NPI

Medfast Urgent Care Centers LLC

  • Urgent Care Clinic/Center
  • Melbourne, FL
National Provider Identifier
1285735605
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
OS6588 Issued in FL
Legal business name
MEDFAST URGENT CARE CENTERS LLC
Practice address
7925 N Wickham Rd
Melbourne, FL 32940-8211
Phone
(321) 409-9443
NPI assigned
Sep 26, 2006
Last updated
Dec 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Authorized official

Name
David Williams, DONPI 1760484034
Title
Managing Member
Phone
(321) 751-7222

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
Urgent Care Clinic/Center 261QU0200X OS6588 FL Primary

Addresses

Primary practice location

7925 N Wickham Rd
Melbourne, FL 32940-8211

Mailing address

7925 N Wickham Rd
Melbourne, FL 32940-8211
Phone (321) 751-7222

Other identifiers 1

IdentifierTypeStateIssuer
OS6588OtherFLMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070514000442 FL Part B Supplier - Clinic/Group Practice 1052418837 Receives reassigned benefits from 115 practitioners
4 other NPIs on this enrollment
Practice locations: Palm Bay, FL; Port St John, FL; Port Orange, FL; Rockledge, FL; Sebastian, FL; Titusville, FL; West Melbourne, FL; Merritt Island, FL…

Other NPIs on the same Medicare enrollment 4

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

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
10D1064428Medfast Urgent Care Centers LLC7925 N Wickham Rd Ste a, Melbourne, FL 32940Certificate of waiverFeb 5, 2027

National Provider Directory

National Provider Directory

Locations

1000 S Ridgewood Ave
Edgewater, FL 32132
Phone (386) 220-8222

1400 Rockledge Blvd
Rockledge, FL 32955
Phone (321) 242-7425

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners & affiliated clinicians

Practitioners 119

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 119

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1285735605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7925 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408211",
            "telephone_number": "321-751-7222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7925 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408211",
            "telephone_number": "321-409-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFAST URGENT CARE CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "321-751-7222",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": "OS6588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "OS6588",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.