Organization Active NPI

Town N Country Medical Care LLC

Doing business as Shital Mehta

  • Primary Care Clinic/Center
  • Tampa, FL
National Provider Identifier
1356926240
Registry record updated Mar 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
TOWN N COUNTRY MEDICAL CARE LLC
Doing business as
Shital Mehta
Practice address
6107 Memorial Hwy Ste a
Tampa, FL 33615-4564
Phone
(813) 514-2328
Fax
(813) 514-2485
NPI assigned
Mar 12, 2021
Last updated
Mar 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2021

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

Authorized official

Name
Mrs. Shital Mehta, DONPI 1861460610
Title
Owner
Phone
(813) 486-6442

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

6107 Memorial Hwy Ste a
Tampa, FL 33615-4564

Mailing address

6107 Memorial Hwy Ste a
Tampa, FL 33615-4564
Phone (813) 514-2328

Other identifiers 1

IdentifierTypeStateIssuer
1861460610MedicaidFL

Other names 1

  • Shital Mehta Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL emr Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220802003853 FL Part B Supplier - Clinic/Group Practice 4789066036 Receives reassigned benefits from 4 practitioners
Practice locations: Tampa, 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
10D2220893Town N Country Medical Care LLC6107 Memorial Hwy Ste a, Tampa, FL 33615Certificate of waiverApr 14, 2027

National Provider Directory

National Provider Directory

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": "1615507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615507200000",
    "number": "1356926240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6107 MEMORIAL HWY STE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336154564",
            "telephone_number": "813-514-2328",
            "fax_number": "813-514-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6107 MEMORIAL HWY STE A",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336154564",
            "telephone_number": "813-514-2328",
            "fax_number": "813-514-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN N COUNTRY MEDICAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "SHITAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-486-6442",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861460610",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "emr",
            "affiliation": "N",
            "endpointDescription": "emr",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6107 Memorial Hwy Ste A",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336154564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Shital Mehta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; 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.