CCRM Florida LLC

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

Legal business name

CCRM FLORIDA LLC

Practice address

19505 Biscayne Blvd
Miami, FL 33180-2314

Phone

(303) 885-5762

NPI assigned

Apr 12, 2022

Organization subpart

No

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

Authorized official

Name

Matt Tyson

Title

Director, Managed Care Contracting

Phone

(615) 477-6677

Specialties & licenses 1

Addresses

Other names 1

• CCRM Florida Other name

Tax ID family

CCRM Florida3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• CCRM Florida LLC

  • Ambulatory Surgical Clinic/Center
  • Miami, FL
  • NPI 1306589809
  NPD tax ID
• CCRM Florida LLC

  • Clinical Medical Laboratory
  • Miami, FL
  • NPI 1336882836
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rachel Cain, APRN

  • Family Nurse Practitioner
  • Miami, FL
  • NPI 1790403723
  NPD (past)
• Callum Potts, M.D.

  • Reproductive Endocrinology Physician
  • Miami, FL
  • NPI 1720461213
  NPD (past)

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784073600000",
    "number": "1487396107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19505 BISCAYNE BLVD STE 2230",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331803644",
            "telephone_number": "305-526-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19505 BISCAYNE BLVD",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331802314",
            "telephone_number": "303-885-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCRM FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-12",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A",
        "authorized_official_last_name": "TYSON",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "DIRECTOR, MANAGED CARE CONTRACTING",
        "authorized_official_telephone_number": "615-477-6677"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCRM Florida",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ccad of South Florida, Inc.
• CCC Home Care Support LLC
• CCR Medical Center, LLC.
• CCRM Florida LLC
• CCRM Florida LLC
• CCRM Florida Surgery LLC
• CDC Medical Group LLC
• CDH Counseling Services Inc.
• Cdixon Incorporated
• CDR Maguire Inc

• Reproductive Endocrinology Physician in Miami, FL
• Providers in Miami, FL by specialty
• Reproductive Endocrinology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.