Organization Active NPI

Town Center Family Care LLC

  • Family Medicine Physician
  • Palm Coast, FL
National Provider Identifier
1396918579
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME61253 Issued in FL
Legal business name
TOWN CENTER FAMILY CARE LLC
Practice address
21 Hospital Dr
Ste 290
Palm Coast, FL 32164-2380
Phone
(386) 473-7977
Fax
(386) 437-7732
NPI assigned
Apr 8, 2008
Last updated
Mar 7, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Authorized official

Name
Dr. Donnette Williams, MDNPI 1013971142
Title
Owner
Phone
(386) 437-7977

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X ME61253 FL
Family Medicine Physician 207Q00000X ME61253 FL Primary

Addresses

Primary practice location

21 Hospital Dr
Ste 290
Palm Coast, FL 32164-2380

Mailing address

PO Box 3123
St Augustine, FL 32085-3123
Phone (904) 824-4990

Other identifiers 1

IdentifierTypeStateIssuer
Y81BDOtherFLFL BLUE

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": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488844800000",
    "number": "1396918579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3123",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320853123",
            "telephone_number": "904-824-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HOSPITAL DR",
            "address_2": "STE 290",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642380",
            "telephone_number": "386-473-7977",
            "fax_number": "386-437-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN CENTER FAMILY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2017-03-07",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DONNETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-437-7977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "FL",
            "license": "ME61253",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME61253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE",
            "identifier": "Y81BD",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; 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.