NPIMap

Organization Active NPI

Complete Local Specialty Care, Inc

Doing business as CLSC

  • Family Medicine Physician
  • Coconut Creek, FL
National Provider Identifier
1538155262
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMPLETE LOCAL SPECIALTY CARE, INC
Doing business as
CLSC
Practice address
5355 Lyons Rd
Coconut Creek, FL 33073-2825
Phone
(954) 570-9595
NPI assigned
Sep 27, 2005
Last updated
Jan 19, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

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

Authorized official

Name
Chantal Bray, BA
Title
Administrator
Phone
(954) 418-1683

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

5355 Lyons Rd
Coconut Creek, FL 33073-2825

Mailing address

4855 W. Hillsboro Blvd Ste B2
Coconut Creek, FL 33073-4356
Phone (954) 418-1683

Other identifiers 2

IdentifierTypeStateIssuer
268799200MedicaidFL
74562OtherFLMEDICARE PTAN

Other names 1

  • CLSC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
CLSC Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

5355 Lyons Rd
Coconut Creek, FL 33073
Phone (954) 570-9595

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HAEGBA

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1538155262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4855 W. HILLSBORO BLVD STE B2",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330734356",
            "telephone_number": "954-418-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5355 LYONS RD",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330732825",
            "telephone_number": "954-570-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE LOCAL SPECIALTY CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "BRAY",
        "authorized_official_first_name": "CHANTAL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "954-418-1683",
        "authorized_official_credential": "BA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268799200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "74562",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLSC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.