Active NPI
Starke Family Medical Center Inc
- General Practice Physician
- Keystone Heights, FL
National Provider Identifier
1407518541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- STARKE FAMILY MEDICAL CENTER INC
- Practice address
- 175 N Lawrence Blvd
Keystone Heights, FL 32656-9351 - Phone
- (352) 473-3199
- NPI assigned
- Oct 6, 2021
- Organization subpart
- Yes
- Parent organization
- STARKE FAMILY MEDICAL CENTER, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michele Denise Bazile
- Title
- Director
- Phone
- (904) 964-5455
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | Primary |
Addresses
Primary practice location
175 N Lawrence Blvd
Keystone Heights, FL 32656-9351
Mailing address
345 W Madison St
Starke, FL 32091-3923
Phone (904) 964-5455
Other names 1
- Village Doctors
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2026125 | Village Doctors Family Medical Center of | Certificate of waiver | Jun 22, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Starke Family Med Center
- Part of
- Starke Family Med Center
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
-
- Family Medicine Physician
- Starke, FL
- NPI 1487727038
-
- General Practice Physician
- Keystone Heights, FL
- NPI 1780348094
-
- General Practice Physician
- Lake Butler, FL
- NPI 1922760065
Interoperability endpoints
- https://api.platform.athenahealth.com/16275/brand/1/csg/1/fhir/r4
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.
-
- Family Medicine Physician
- Starke, FL
- NPI 1487727038
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633478400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1633478400000",
"number": "1407518541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 W MADISON ST",
"city": "STARKE",
"state": "FL",
"postal_code": "320913923",
"telephone_number": "904-964-5455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "175 N LAWRENCE BLVD",
"city": "KEYSTONE HEIGHTS",
"state": "FL",
"postal_code": "326569351",
"telephone_number": "352-473-3199"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STARKE FAMILY MEDICAL CENTER INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "STARKE FAMILY MEDICAL CENTER, INC.",
"enumeration_date": "2021-10-06",
"last_updated": "2021-10-06",
"certification_date": "2021-10-06",
"status": "A",
"authorized_official_last_name": "BAZILE",
"authorized_official_first_name": "MICHELE",
"authorized_official_middle_name": "DENISE",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "904-964-5455"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Village Doctors",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Keystone Heights, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.