Organization Active NPI

Citrus Specialty Group, Inc

  • Surgery Physician
  • Inverness, FL
National Provider Identifier
1437552858
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CITRUS SPECIALTY GROUP, INC
Practice address
403 W Highland Blvd
Inverness, FL 34452-4717
Phone
(352) 726-3646
Fax
(352) 726-0079
NPI assigned
Sep 30, 2014
Last updated
Oct 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Authorized official

Name
William Tedrick Johnson
Title
Vice President/Ao
Phone
(615) 372-3375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

403 W Highland Blvd
Inverness, FL 34452-4717

Mailing address

2000 Health Park Dr
Brentwood, TN 37027-4525
Phone (615) 372-7600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141219001065 FL Part B Supplier - Clinic/Group Practice 8022331255 Receives reassigned benefits from 18 practitioners
Practice locations: Lecanto, FL; Trinity, FL; Spring Hill, FL; Inverness, FL; Brooksville, FL; Brandon, FL

National Provider Directory

National Provider Directory

Locations

104 S Pine Ave
Inverness, FL 34452
Phone (352) 726-3646

131 S Citrus Ave
Ste 101
Inverness, FL 34452
Phone (352) 560-6270

131 S Citrus Ave
Ste 203
Inverness, FL 34452
Phone (352) 344-6930

510 N Lecanto Hwy
Ste 510
Lecanto, FL 34461
Phone (352) 746-9040

520 N Lecanto Hwy
Ste 540
Lecanto, FL 34461
Phone (352) 746-9040

10461 Quality Dr
Spring Hill, FL 34609
Phone (352) 688-3002

9332 State Road 54
Trinity, FL 34655
Phone (727) 834-4833

9332 State Road 54
Ste 407
Trinity, FL 34655
Phone (727) 375-7295

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1437552858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274525",
            "telephone_number": "615-372-7600",
            "fax_number": "866-346-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 W HIGHLAND BLVD",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344524717",
            "telephone_number": "352-726-3646",
            "fax_number": "352-726-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITRUS SPECIALTY GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-30",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TEDRICK",
        "authorized_official_title_or_position": "VICE PRESIDENT/AO",
        "authorized_official_telephone_number": "615-372-3375"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inverness, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.