NPIMap

Organization Active NPI

Church Street Medical Center

  • Internal Medicine Physician
  • Dade City, FL
National Provider Identifier
1326215641
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CHURCH STREET MEDICAL CENTER
Practice address
13417 US Highway 301
Dade City, FL 33525-5446
Phone
(352) 567-5136
Fax
(352) 567-1321
NPI assigned
May 15, 2008
Last updated
Oct 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Authorized official

Name
Chandresh SaraiyaNPI 1710908967
Title
President
Phone
(813) 783-3118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

13417 US Highway 301
Dade City, FL 33525-5446

Mailing address

38135 Market SQ
Zephyrhills, FL 33542-7505
Phone (813) 780-1255

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": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317859200000",
    "number": "1326215641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38135 MARKET SQ",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335427505",
            "telephone_number": "813-780-1255",
            "fax_number": "813-780-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13417 US HIGHWAY 301",
            "city": "DADE CITY",
            "state": "FL",
            "postal_code": "335255446",
            "telephone_number": "352-567-5136",
            "fax_number": "352-567-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCH STREET MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2011-10-06",
        "status": "A",
        "authorized_official_last_name": "SARAIYA",
        "authorized_official_first_name": "CHANDRESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-783-3118"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dade City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.