NPIMap

Organization Active NPI

Paxton Medical Management

Doing business as Family Doctors of North Port

  • Family Medicine Physician
  • North Port, FL
National Provider Identifier
1457950420
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PAXTON MEDICAL MANAGEMENT
Doing business as
Family Doctors of North Port
Practice address
14279 Tamiami TRL
North Port, FL 34287-2215
Phone
(941) 263-2050
NPI assigned
Oct 21, 2020
Last updated
Oct 21, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
PAXTON MEDICAL MANAGEMENTAs reported in NPPES

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
John Grove
Title
Chief Operating Officer
Phone
(727) 581-7212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

14279 Tamiami TRL
North Port, FL 34287-2215

Mailing address

8050 Seminole Blvd
Seminole, FL 33772-4808
Phone (727) 275-2005

Other names 1

  • Family Doctors of North Port Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201207002092 FL Part B Supplier - Clinic/Group Practice 7214349737 Receives reassigned benefits from 7 practitioners
2 other NPIs on this enrollment
Practice locations: Englewood, FL; North Port, FL; Sun City Center, FL

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2221262Paxton Medical Management, Inc14279 S Tamiami Trail, North Port, FL 34287Certificate of waiverApr 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
Paxton Medical Management4 organizations share this tax ID, including this one
Part of
Paxton Medical Management

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1457950420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8050 SEMINOLE BLVD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337724808",
            "telephone_number": "727-275-2005",
            "fax_number": "727-498-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14279 TAMIAMI TRL",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342872215",
            "telephone_number": "941-263-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAXTON MEDICAL MANAGEMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAXTON MEDICAL MANAGEMENT",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "GROVE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "727-581-7212"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Doctors of North Port",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Port, 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.
  • 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.

Verify at the official NPI Registry.