Mdy Primary Care Medicine P a

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0072925 Issued in FL

Legal business name

MDY PRIMARY CARE MEDICINE P A

Practice address

102 Park Place Blvd
Davenport, FL 33837-6857

Phone

(863) 422-0032

Fax

(863) 422-3275

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Margaret R Yee, MD

Title

Owner

Phone

(863) 422-0032

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 4

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

• Tayyaba Nadir Tariq, MD

  • Family Medicine Physician
  • Davenport, FL
  • NPI 1003892498
  NPD
• Tatiana L Mesa Santander, PA-C

  • Physician Assistant
  • Windermere, FL
  • NPI 1356712541
  NPD (past)
• Lynsey Souther, PA-C

  • Adult Medicine Physician
  • Davenport, FL
  • NPI 1730665936
  NPD (past)
• Alyssa D Grisham, PA-C

  • Medical Physician Assistant
  • West Columbia, SC
  • NPI 1962913921
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483401600000",
    "number": "1497974133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 PARK PLACE BLVD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338376857",
            "telephone_number": "863-422-0032",
            "fax_number": "863-422-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 PARK PLACE BLVD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338376857",
            "telephone_number": "863-422-0032",
            "fax_number": "863-422-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDY PRIMARY CARE MEDICINE P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2017-01-03",
        "status": "A",
        "authorized_official_last_name": "YEE",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-422-0032",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0072925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER",
            "identifier": "DG2237",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Grace McGovern
• Michael Shamus McHale, DO
• Roderick John McKenzie, PA-C
• Melissa Lee McNally, PA
• Steven McNew, PT, DPT
• Medical Home Alliance LLC
• Medical Home Alliance LLC
• Medical Home Alliance LLC
• Medical Home Alliance LLC
• Marko Anthony Medina, PTA

• Specialist in Davenport, FL
• Providers in Davenport, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.