Family First Wellness Clinic, LLC
Organization Active NPI Family Medicine Physician · Madison, FL
NPI 1508106063 · NPPES record last updated Mar 10, 2017
Key facts
- NPI
- 1508106063
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- FAMILY FIRST WELLNESS CLINIC, LLC
- Practice address
- 486 SW Rutledge Street
Madison, FL 32340 - Phone
- (850) 973-8851
- Fax
- (850) 973-8365
- NPI assigned
- Feb 20, 2013
- Organization subpart
- No
Authorized official
- Name
- Mrs. Rachael Eugenia Sapp, ARNP-C
- Title
- Co-Owner
- Phone
- (850) 973-8851
Practitioners 5
-
Daniel B Perkins, MD
-
Rachael E Sapp, ARNP
-
Tiffany S Strickland, APRN-C
-
Michele B Richardson, ARNP,FNP-BC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D0885865 | Family First Wellness Clinic Inc | Certificate of waiver | May 3, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130529000495 | FL | Part B Supplier - Clinic/Group Practice | 0446498604 |
Receives reassigned benefits from 5 practitioners Practice locations: Madison, FL |
National Provider Directory
Locations
486 SW Rutledge St
Madison, FL 32340
Phone (850) 973-8851
259 SW Captain Brown Rd
Madison, FL 32340
Phone (850) 973-8277
Interoperability endpoints
- https://api.platform.athenahealth.com/11819/brand/1/csg/1/fhir/r4
- https://fhir4.healow.com/fhir/r4/JDECCA
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
486 SW Rutledge Street
Madison, FL 32340
Mailing address
486 SW Rutledge Street
Madison, FL 32340
Phone (850) 973-8851
Other providers in Madison, FL
- Richard Edwards
- Emma'S Helping Hands
- Charles Wesley Evans
- Victory Clairissa Elizabeth Evans
- Falo Hill
- Matesha Fead
- Kenol Junior Felix
- Juanita Webb Fico
- Florida Assistant Living Organization, LLC
- Florida Assistant Living Organization, LLC
All providers in Madison, FL · Family Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 10, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.