NPIMap

Organization Active NPI

MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bradenton, FL
National Provider Identifier
1417649658
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MCR HEALTH, INC.
Practice address
300 Riverside Dr E Ste 2400
Bradenton, FL 34208-1006
Phone
(941) 405-1170
NPI assigned
May 25, 2023
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Melvin B Price
Title
President/Ceo
Phone
(941) 776-4000

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

300 Riverside Dr E Ste 2400
Bradenton, FL 34208-1006

Mailing address

101 Riverfront Blvd Ste 710
Bradenton, FL 34205-8812
Phone (941) 776-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230628003324 FL Part A Provider - Federally Qualified Health Center (FQHC) 7214847995 Practice locations: Bradenton, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1417649658. Details of each certification follow.

Federally qualified health center certification: CCN 691067

Legal name
MCR HEALTH INC
Doing business as
RIVERSIDE MEDICAL CENTER - PULMONOLOGY
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 22, 2023
Last certification
Jun 22, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 11, 1978 in FL
Enrollment address
300 Riverside Dr E
Ste 2400
Bradenton, FL 34208-1006

National Provider Directory

National Provider Directory
Tax ID family
Manatee County Rural He130 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 12

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mary L Ruiz Individual Corporate Director Nov 29, 2023
Janene M Amick Individual Corporate Director Nov 29, 2023
Daniel J Friedrick Individual Corporate Director Nov 29, 2023
Reginald J Bellamy Individual Corporate Director Nov 29, 2023
Leroy J Washington Individual Corporate Director Nov 29, 2023
Stephen S Wicker Individual Corporate Director Nov 29, 2023
Lynette Edwards Individual Corporate Director Nov 29, 2023
Edna Y Baugh Individual Corporate Director Nov 29, 2023
Daniel Jaime Individual Corporate Director Nov 29, 2023
Melvin B Price Individual Corporate OfficerPresident/Ceo Nov 9, 2022
Operational/Managerial ControlPresident & Ceo Nov 9, 2022
MCR Health Inc Organization, Bradenton, FL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Oct 11, 1977
Kathleen a Hargreaves Individual Corporate Director Nov 29, 2023

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 15

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Whole Child Pediatrics and River Landing OB/GYNBradenton, FL, CCN 101049 Federally qualified health center 5% Or Greater Direct Ownership Interest Nov 2, 2009
North Manatee Family Healthcare CenterPalmetto, FL, CCN 101887 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 11, 1977
Southwest Health CenterBradenton, FL, CCN 101895 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 11, 1977
West Manatee Health CenterBradenton, FL, CCN 101071 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 11, 1977
Bradenton Family Medical CenterBradenton, FL, CCN 101094 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 11, 1977
MCR Health IncBradenton, FL, CCN 101144 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 11, 1977
MCR Health Arcadia PodiatryArcadia, FL, CCN 101188 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 11, 1977
Riverside Medical ServicesBradenton, FL, CCN 101192 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 11, 1977
MCR Health IncArcadia, FL, CCN 681021 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 11, 1977
Community Care Family Clinic Counseling ServicesArcadia, FL, CCN 681026 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Apr 11, 1978
Twin Rivers Medical CenterArcadia, FL, CCN 681027 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 11, 1977
South County Medical CenterEnglewood, FL, CCN 681055 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 11, 1977
MCR HealthSarasota, FL, CCN 681049 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 11, 1977
Southeast Family Healthcare CenterBradenton, FL, CCN 681195 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Oct 11, 1977
Riverside Medical CenterBradenton, FL, CCN 691016 Federally qualified health center 5% Or Greater Direct Ownership Interest Oct 11, 1977

Facilities with the same owner 15

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1417649658",
    "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": "300 RIVERSIDE DR E STE 2400",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342081006",
            "telephone_number": "941-405-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCR HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "941-776-4000"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.