NPIMap

Organization Active NPI

Collier Health Services Inc

Doing business as Healthcare Network

  • Federally Qualified Health Center (FQHC)
  • Naples, FL
National Provider Identifier
1417161852
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COLLIER HEALTH SERVICES INC
Doing business as
Healthcare Network
The Mike Davis Medical Center
Practice address
12655 Collier Blvd
Naples, FL 34116-4005
Phone
(239) 658-3000
NPI assigned
May 9, 2007
Last updated
Apr 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Authorized official

Name
Tami Raznoff
Title
Cfo
Phone
(239) 658-3707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

12655 Collier Blvd
Naples, FL 34116-4005

Mailing address

1454 Madison Ave W
Immokalee, FL 34142-2200
Phone (239) 658-3707

Other practice location 1

1755 Heritage Trl
Suite 604
Naples, FL 34112-7591
Phone (239) 353-4101

Other identifiers 1

IdentifierTypeStateIssuer
683955003MedicaidFL

Other names 2

  • Healthcare Network Doing business as
  • The Mike Davis Medical Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1417161852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 MADISON AVE W",
            "city": "IMMOKALEE",
            "state": "FL",
            "postal_code": "341422200",
            "telephone_number": "239-658-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12655 COLLIER BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341164005",
            "telephone_number": "239-658-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1755 Heritage Trl",
            "address_2": "Suite 604",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341127591",
            "country_code": "US",
            "telephone_number": "239-353-4101",
            "fax_number": "239-353-4231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLLIER HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "RAZNOFF",
        "authorized_official_first_name": "TAMI",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "239-658-3707"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "683955003",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthcare Network",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Mike Davis Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Mike Davis Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; 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.