NPIMap

Organization Active NPI

Tequesta Family Medical Center, LLC

  • Family Medicine Physician
  • Tequesta, FL
National Provider Identifier
1396099883
Registry record updated Nov 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME78193 Issued in FL
Legal business name
TEQUESTA FAMILY MEDICAL CENTER, LLC
Practice address
851 N US Highway 1
Tequesta, FL 33469-2348
Phone
(561) 743-8362
NPI assigned
Nov 5, 2012
Last updated
Nov 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2012

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

Authorized official

Name
Mark Lange Corry, M.D.NPI 1093898397
Title
President
Phone
(561) 743-8362

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X ME78193 FL Primary

Addresses

Primary practice location

851 N US Highway 1
Tequesta, FL 33469-2348

Mailing address

851 N US Highway 1
Tequesta, FL 33469-2348
Phone (561) 743-8362

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": "1352073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352073600000",
    "number": "1396099883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 N US HIGHWAY 1",
            "city": "TEQUESTA",
            "state": "FL",
            "postal_code": "334692348",
            "telephone_number": "561-743-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 N US HIGHWAY 1",
            "city": "TEQUESTA",
            "state": "FL",
            "postal_code": "334692348",
            "telephone_number": "561-743-8362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEQUESTA FAMILY MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-05",
        "last_updated": "2012-11-05",
        "status": "A",
        "authorized_official_last_name": "CORRY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "LANGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-743-8362",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME78193",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 5, 2012; 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.