NPIMap

Organization Active NPI

Campbellton-Graceville Hospital

Doing business as Campbellton-Graceville Hospital Physicians' Office

  • Family Health Clinical Nurse Specialist
  • Graceville, FL
National Provider Identifier
1407169733
Registry record updated Jul 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X
Legal business name
CAMPBELLTON-GRACEVILLE HOSPITAL
Doing business as
Campbellton-Graceville Hospital Physicians' Office
Practice address
5429 College Dr Ste B
Graceville, FL 32440-1859
Phone
(850) 263-4431
Fax
(850) 263-3312
NPI assigned
Jul 15, 2010
Last updated
Jul 15, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
CAMPBELLTON-GRACEVILLE HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2010

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

Authorized official

Name
Mrs. Judith P Austin
Title
Asst Administrator
Phone
(850) 263-4431

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X ZZ Primary

Addresses

Primary practice location

5429 College Dr Ste B
Graceville, FL 32440-1859

Mailing address

5429 College Dr Ste B
Graceville, FL 32440-1859
Phone (850) 263-4431

Other names 1

  • CAMPBELLTON-GRACEVILLE HOSPITAL PHYSICIANS' OFFICE Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Atul Madan MD3 organizations share this tax ID, including this one
Part of
Atul Madan MD

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279152000000",
    "number": "1407169733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5429 COLLEGE DR STE B",
            "city": "GRACEVILLE",
            "state": "FL",
            "postal_code": "324401859",
            "telephone_number": "850-263-4431",
            "fax_number": "850-263-3312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5429 COLLEGE DR STE B",
            "city": "GRACEVILLE",
            "state": "FL",
            "postal_code": "324401859",
            "telephone_number": "850-263-4431",
            "fax_number": "850-263-3312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELLTON-GRACEVILLE HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAMPBELLTON-GRACEVILLE HOSPITAL",
        "enumeration_date": "2010-07-15",
        "last_updated": "2010-07-15",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ASST ADMINISTRATOR",
        "authorized_official_telephone_number": "850-263-4431",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "ZZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMPBELLTON-GRACEVILLE HOSPITAL PHYSICIANS' OFFICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Graceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2010; 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.