Andres R Villar MD

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

ANDRES R VILLAR MD

Practice address

1002 11TH St SW
Live Oak, FL 32064-3606

Phone

(386) 364-8050

Fax

(386) 364-7068

NPI assigned

Oct 3, 2006

Organization subpart

No

Name

Andres R Villar, MDNPI 1164421855

Title

Administrator

Phone

(386) 755-5044

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

• Andres R Villar MD

  • Rural Health Clinic/Center
  • Lake City, FL
  • NPI 1497754154

  5092623439

  Same PAC ID
• Andres R Villar MD

  • Rural Health Clinic/Center
  • Macclenny, FL
  • NPI 1538253638

  5092623439

  Same PAC ID
• Andres R Villar MD

  • Rural Health Clinic/Center
  • Alachua, FL
  • NPI 1801980909

  5092623439

  Same PAC ID
• Andres R. Villar MD

  • Rural Health Clinic/Center
  • Glen St Mary, FL
  • NPI 1629162722

  5092623439

  Same PAC ID

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andres R Villar, MD

  • Pediatrics Physician
  • Lake City, FL
  • NPI 1164421855

  Pediatrics

  NPD (past) Authorized official
• Kevin Horn, ARNP

  • Pediatric Nurse Practitioner
  • Newberry, FL
  • NPI 1205808128
  NPD (past)
• Jan Gurney, D.O.

  • Family Medicine Physician
  • Somerville, NJ
  • NPI 1447244793
  NPD (past)

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Rural health clinic certification: CCN 103868

Legal name

ANDRES R VILLAR MD

Doing business as

CHILDREN'S MEDICAL CENTER LIVE OAK

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Jul 7, 1994

Last certification

Aug 2, 2019

Ownership / control type

For profit – corporation

Organization structure

CorporationProprietary

Incorporated

Apr 16, 1992 in FL

Enrollment address

1002 11TH SWST
Live Oak, FL 32064-3606

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

Tax ID family

Andres R Villar MD6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

• Andres R Villar MD

  • Rural Health Clinic/Center
  • Macclenny, FL
  • NPI 1538253638
  NPD tax ID
• Andres R Villar MD

  • Rural Health Clinic/Center
  • Alachua, FL
  • NPI 1801980909
  NPD tax ID
• Andres R Villar MD

  • Pediatrics Physician
  • Live Oak, FL
  • NPI 1902571532
  NPD tax ID
• Andres R. Villar MD

  • Rural Health Clinic/Center
  • Glen St Mary, FL
  • NPI 1629162722
  NPD tax ID
• Andres R. Villar MD

  • Pediatrics Physician
  • Alachua, FL
  • NPI 1710071816
  NPD tax ID

Locations

• Children's Medical Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 22, 2021.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626912000000",
    "number": "1295829398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 606",
            "city": "GLEN ST MARY",
            "state": "FL",
            "postal_code": "320400606",
            "telephone_number": "904-653-1818",
            "fax_number": "904-653-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 11TH ST SW",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320643606",
            "telephone_number": "386-364-8050",
            "fax_number": "386-364-7068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDRES R VILLAR MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A",
        "authorized_official_last_name": "VILLAR",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "386-755-5044",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID RURAL HEALTH CLINIC",
            "identifier": "370861601",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Children's Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Angels Touch Elite Transportation
• Angels With Care LLC
• Anjana Rana

• All providers in Live Oak, FL
• Rural Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.