Organization Active NPI

Early Ambulatory Medicine LLC

  • Primary Care Clinic/Center
  • Clermont, FL
National Provider Identifier
1356655989
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
EARLY AMBULATORY MEDICINE LLC
Practice address
740 Lake Ave
Clermont, FL 34711-2243
Phone
(352) 243-6900
Fax
(352) 243-6902
NPI assigned
Aug 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Authorized official

Name
Dr. Carole K Early, M.D.NPI 1790787893
Title
Owner/Sole Proprietor
Phone
(352) 243-6900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

740 Lake Ave
Clermont, FL 34711-2243

Mailing address

740 Lake Ave
Clermont, FL 34711-2243
Phone (352) 243-6900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100825000775 FL Part B Supplier - Clinic/Group Practice 4688798846 Receives reassigned benefits from 1 practitioner
Practice locations: Clermont, FL

National Provider Directory

National Provider Directory

Locations

740 Lake Ave
Clermont, FL 34711
Phone (352) 243-6900

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281052800000",
    "number": "1356655989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 LAKE AVE",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347112243",
            "telephone_number": "352-243-6900",
            "fax_number": "352-243-6902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 LAKE AVE",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347112243",
            "telephone_number": "352-243-6900",
            "fax_number": "352-243-6902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EARLY AMBULATORY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-06",
        "last_updated": "2010-08-06",
        "status": "A",
        "authorized_official_last_name": "EARLY",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/SOLE PROPRIETOR",
        "authorized_official_telephone_number": "352-243-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.