MCR Health, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MCR HEALTH, INC.

Practice address

508 S 6TH Ave
Wauchula, FL 33873-3211

Phone

(863) 473-4733

NPI assigned

Aug 15, 2018

Organization subpart

No

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

Authorized official

Name

Patrick Carnegie

Title

President and Ceo

Phone

(941) 776-4000

Specialties & licenses 3

Addresses

Other names 1

• AMA WAUCHULA Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 681137

Legal name

AMA WACHULA

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Dec 26, 2018

Last certification

Dec 26, 2018

Ownership / control type

For profit – partnership

Facility address

508 South 6TH Avenue
Wachula, FL 33873

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1417437872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RIVERFRONT BLVD STE 710",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058812",
            "telephone_number": "941-776-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S 6TH AVE",
            "city": "WAUCHULA",
            "state": "FL",
            "postal_code": "338733211",
            "telephone_number": "863-473-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCR HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-15",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "CARNEGIE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "941-776-4000"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMA WAUCHULA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Martin, LMHC
• Lucy Mason, MSOT, OTR/L
• Varghese E Mathai, MD
• Lucy Jayne Matos, L.M.T
• Karen E McKenzie, DMD
• MCR Health, Inc.
• Gregorio Nunez Medalle, MD
• Christy A Merrick, ARNP
• Adna Metayer
• Miles S Judah, Inc

• Federally Qualified Health Center (FQHC) in Wauchula, FL
• Providers in Wauchula, FL by specialty
• Federally Qualified Health Center (FQHC) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.