Williston Rural Health and Wellness Clinic LLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

WILLISTON RURAL HEALTH AND WELLNESS CLINIC LLC

Practice address

300 NW 1St Ave
Williston, FL 32696-2006

Phone

(352) 529-0966

Fax

(352) 529-0967

NPI assigned

Mar 27, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Sidney Ernest Clevinger, M.D.NPI 1760461974

Title

Medical Director

Phone

(352) 266-7075

Specialties & licenses 1

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• CNS Holding Company LLC

  • Rural Health Clinic/Center
  • Williston, FL
  • NPI 1952712713

  Member Of

  NPD member

Practitioners 1

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

• Sidney Ernest Clevinger, MD

  • Family Medicine Physician
  • Ocala, FL
  • NPI 1760461974
  NPD (past) Authorized official

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381363200000",
    "number": "1538435375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 NW 1ST AVE",
            "city": "WILLISTON",
            "state": "FL",
            "postal_code": "326962006",
            "telephone_number": "352-529-0966",
            "fax_number": "352-529-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 NW 1ST AVE",
            "city": "WILLISTON",
            "state": "FL",
            "postal_code": "326962006",
            "telephone_number": "352-529-0966",
            "fax_number": "352-529-0967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLISTON RURAL HEALTH AND WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-27",
        "last_updated": "2013-10-10",
        "status": "A",
        "authorized_official_last_name": "CLEVINGER",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_middle_name": "ERNEST",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "352-266-7075",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Williston Health Care Center, LLC
• Williston Nursing and Rehab LLC
• Williston Pediatrics, Inc
• Williston Pediatrics, Inc
• Williston Rehabilitation and Nursing Center LLC

• Rural Health Clinic/Center in Williston, FL
• Providers in Williston, FL by specialty
• Rural Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2013; 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.