Organization Active NPI

Tequesta Health Center, Inc

  • Family Medicine Physician
  • Tequesta, FL
National Provider Identifier
1306067509
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TEQUESTA HEALTH CENTER, INC
Practice address
169 Tequesta Dr
Suite 12E
Tequesta, FL 33469-2768
Phone
(561) 747-7672
Fax
(561) 743-3667
NPI assigned
May 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Authorized official

Name
Dr. Mark L Corry, M.D
Title
Physician Manager
Phone
(561) 747-7672

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X FL Primary

Addresses

Primary practice location

169 Tequesta Dr
Suite 12E
Tequesta, FL 33469-2768

Mailing address

169 Tequesta Dr
Suite 12E
Tequesta, FL 33469-2768
Phone (561) 747-7672

Other identifiers 1

IdentifierTypeStateIssuer
38678OtherFLBCBS GROUP NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1306067509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 TEQUESTA DR",
            "address_2": "SUITE 12E",
            "city": "TEQUESTA",
            "state": "FL",
            "postal_code": "334692768",
            "telephone_number": "561-747-7672",
            "fax_number": "561-743-3667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 TEQUESTA DR",
            "address_2": "SUITE 12E",
            "city": "TEQUESTA",
            "state": "FL",
            "postal_code": "334692768",
            "telephone_number": "561-747-7672",
            "fax_number": "561-743-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEQUESTA HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "CORRY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHYSICIAN MANAGER",
        "authorized_official_telephone_number": "561-747-7672",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "38678",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tequesta, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.