Florida Primary Care and Sports Medicine, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FLORIDA PRIMARY CARE AND SPORTS MEDICINE, INC.

Practice address

140 Pinnacles Dr
Palm Coast, FL 32164-2322

Phone

(386) 597-2829

Fax

(386) 313-1923

NPI assigned

Sep 10, 2019

Organization subpart

No

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

Authorized official

Name

Ann Shaw

Title

Administrator

Phone

(386) 447-6615

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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

• Brian Thomas Bogdanowicz, M.D.

  • Family Medicine Physician
  • Daytona Beach, FL
  • NPI 1265751267
  Medicare reassignment Care Compare group NPD
• Natalie Ann Ingerski, APRN, FNP-BC

  • Family Nurse Practitioner
  • Palm Coast, FL
  • NPI 1609522333
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751328000000",
    "number": "1548819741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 OFFICE PARK DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373808",
            "telephone_number": "386-447-6615",
            "fax_number": "386-447-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PINNACLES DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642322",
            "telephone_number": "386-597-2829",
            "fax_number": "386-313-1923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA PRIMARY CARE AND SPORTS MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-10",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "386-447-6615"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Florida Healthcare Pharmacy
• Florida Heart & Vascular Care, PLLC
• Florida Hospital Flagler
• Florida Institute of Pain Medicine LLC (Florida Pain Physicians)
• Florida Oncology Network PA
• Florida Sedation, Implant and Dental Surgery Associates, LLC (Dental Specialists of North Florida)
• Florida Woman Care, LLC
• Florida Woman Care, LLC
• Florida Woman Care, LLC
• Elise Matos Flowers

• Family Medicine Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.