NPIMap

Organization Active NPI

Halifax Healthcare Systems Inc

  • Pediatrics Physician
  • Daytona Beach, FL
National Provider Identifier
1477596641
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
HALIFAX HEALTHCARE SYSTEMS INC
Practice address
431 Keech Street
Daytona Beach, FL 32114
Phone
(386) 947-3553
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. Arvin Lewis
Title
Vppbfs
Phone
(386) 254-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

431 Keech Street
Daytona Beach, FL 32114

Mailing address

431 Keech Street
Daytona Beach, FL 32114
Phone (386) 947-3553

Other names 1

  • HHCSI Keech Street Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031218000443 FL Part B Supplier - Clinic/Group Practice 1254238090 Receives reassigned benefits from 827 practitioners
25 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Deltona, FL; Daytona Beach, FL; New Smyrna, FL; New Smyrna Beach, FL; Ormond Beach, FL; Port Orange, FL

Other NPIs on the same Medicare enrollment 25

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

View all 25

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1477596641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 KEECH STREET",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32114",
            "telephone_number": "386-947-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 KEECH STREET",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "32114",
            "telephone_number": "386-947-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALIFAX HEALTHCARE SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "ARVIN",
        "authorized_official_title_or_position": "VPPBFS",
        "authorized_official_telephone_number": "386-254-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HHCSI Keech Street Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.