NPIMap

Organization Active NPI

Williston Family Practice,PA

  • Family Medicine Physician
  • Williston, FL
National Provider Identifier
1295938785
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WILLISTON FAMILY PRACTICE,PA
Practice address
111 W Noble Ave
Williston, FL 32696-2027
Phone
(352) 529-1111
Fax
(352) 529-1115
NPI assigned
Jun 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Authorized official

Name
Erica Natasha McBride
Title
Officemanager
Phone
(352) 529-1111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

111 W Noble Ave
Williston, FL 32696-2027

Mailing address

111 W Noble Ave
Williston, FL 32696-2027
Phone (352) 529-1111

National Provider Directory

National Provider Directory

Locations

111 W Noble Ave
Williston, FL 32696
Phone (352) 529-1111

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290038400000",
    "number": "1295938785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W NOBLE AVE",
            "city": "WILLISTON",
            "state": "FL",
            "postal_code": "326962027",
            "telephone_number": "352-529-1111",
            "fax_number": "352-529-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W NOBLE AVE",
            "city": "WILLISTON",
            "state": "FL",
            "postal_code": "326962027",
            "telephone_number": "352-529-1111",
            "fax_number": "352-529-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLISTON FAMILY PRACTICE,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-11",
        "last_updated": "2010-11-18",
        "status": "A",
        "authorized_official_last_name": "MCBRIDE",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "NATASHA",
        "authorized_official_title_or_position": "OFFICEMANAGER",
        "authorized_official_telephone_number": "352-529-1111"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; 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.