Organization Active NPI

Stat Medical Clinic III Inc

  • Health Service Clinic/Center
  • Hallandale Beach, FL
National Provider Identifier
1316177470
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
STAT MEDICAL CLINIC III INC
Practice address
800 E Hallandale Beach Blvd
Suite #22
Hallandale Beach, FL 33009-4477
Phone
(954) 456-1212
Fax
(954) 456-0748
NPI assigned
Jul 22, 2009
Last updated
May 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2012

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

Authorized official

Name
Patrice Pryce
Title
Billing
Phone
(954) 568-1033

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

800 E Hallandale Beach Blvd
Suite #22
Hallandale Beach, FL 33009-4477

Mailing address

800 E Hallandale Beach Blvd
Suite #22
Hallandale Beach, FL 33009-4477
Phone (954) 456-1212

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130306000210 FL Part B Supplier - Clinic/Group Practice 2163677683 Receives reassigned benefits from 1 practitioner
Practice locations: Hallandale Beach, FL

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
10D0880250Stat Medical Clinic III Inc800 E Hallandale Beach Blvd Ste 22, Hallandale, FL 33009Certificate of waiverDec 7, 2027

National Provider Directory

National Provider Directory

Locations

800 E Hallandale Beach Blvd
Ste 22
Hallandale Beach, FL 33009
Phone (954) 456-1212

Practitioners & affiliated clinicians

Practitioners 4

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": "1248220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337299200000",
    "number": "1316177470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E HALLANDALE BEACH BLVD",
            "address_2": "SUITE #22",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094477",
            "telephone_number": "954-456-1212",
            "fax_number": "954-456-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E HALLANDALE BEACH BLVD",
            "address_2": "SUITE #22",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094477",
            "telephone_number": "954-456-1212",
            "fax_number": "954-456-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAT MEDICAL CLINIC III INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-22",
        "last_updated": "2012-05-18",
        "status": "A",
        "authorized_official_last_name": "PRYCE",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "954-568-1033"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; 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.