MCR Health, Inc.

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

MCR HEALTH, INC.

Doing business as

AMA Health Gulf Coast Pedaitrics

Practice address

5305 E State Road 64
Bradenton, FL 34208-5534

Phone

(941) 747-2242

NPI assigned

Jun 28, 2019

Last updated

Jun 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melvin B Price

Title

President and Ceo

Phone

(941) 776-4000

Specialties & licenses 2

Addresses

Other names 1

• AMA Health Gulf Coast Pedaitrics Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528620671. Details of each certification follow.

• CCN 681150 Federally qualified health center · Active · Details

Federally qualified health center certification: CCN 681150

Legal name

MCR HEALTH INC

Doing business as

MCR HEALTH FRUITVILLE

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Jul 19, 2019

Last certification

Jul 19, 2019

Ownership / control type

For profit – partnership

Organization structure

CorporationNon-profit

Incorporated

Apr 11, 1978 in FL

Enrollment address

170 N Lime Ave
Sarasota, FL 34237-6122

Other NPIs on the same Medicare enrollment 1

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

• MCR Health, Inc.

  dba MCR Health Fruitville

  • Federally Qualified Health Center (FQHC)
  • Sarasota, FL
  • NPI 1497329825

  O20190719001601

  Same enrollment

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Melvin Bernard Price, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Bradenton, FL
  • NPI 1841267424

  Corporate Officer, Operational/Managerial Control

  CMS ownership

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

{
    "created_epoch": "1561680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686528000000",
    "number": "1528620671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 RIVERFRONT BLVD STE 710",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058812",
            "telephone_number": "941-776-4000",
            "fax_number": "941-845-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 E STATE ROAD 64",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342085534",
            "telephone_number": "941-747-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCR HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-28",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "MELVIN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "941-776-4000"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMA Health Gulf Coast Pedaitrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AMA Health Gulf Coast Pedaitrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• MCR Health, Inc. (Advanced Specialty Institute Pain Mgmt II)
• MCR Health, Inc. (Cortez Dental)
• MCR Health, Inc. (Advanced Specialty Institute Podiatry)
• MCR Health, Inc. (Advanced Specialty Institute Podiatry II)
• MCR Health, Inc. (Manatee Elementary School Based Health Center)
• MCR Health, Inc. (Advanced Specialty Institute Gastroenterology)

• Federally Qualified Health Center (FQHC) in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Federally Qualified Health Center (FQHC) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.