NPIMap

Organization Active NPI

Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Palm Bay, FL
National Provider Identifier
1467124271
Registry record updated Sep 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MEDFAST URGENT CARE CENTERS, LLC
Practice address
820 Palm Bay Rd NE Ste 110
Palm Bay, FL 32905-6351
Phone
(321) 633-3278
NPI assigned
Sep 30, 2021
Last updated
Sep 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2021

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

Authorized official

Name
Marilyn Stevens
Title
Billing Director
Phone
(321) 821-4950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

820 Palm Bay Rd NE Ste 110
Palm Bay, FL 32905-6351

Mailing address

390 N Courtenay Pkwy
Merritt Island, FL 32953-3456
Phone (321) 633-4852

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
10D2240201Medfast Urgent Care Centers LLC820 Palm Bay Rd Suite 110, Palm Bay, FL 32905Certificate of waiverOct 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Medfast Urgent Care Centersllc20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Locations

820 Palm Bay Rd NE
Ste 110
Palm Bay, FL 32905
Phone (321) 409-8140

NPI Registry JSON

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

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632960000000",
    "number": "1467124271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533456",
            "telephone_number": "321-633-4852",
            "fax_number": "321-684-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 PALM BAY RD NE STE 110",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329056351",
            "telephone_number": "321-633-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFAST URGENT CARE CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "321-821-4950"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Bay, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.