NPIMap

Organization Active NPI

Outpatient Clinic at Penney Retirement Community, Inc.

  • Family Medicine Physician
  • Penney Farms, FL
National Provider Identifier
1578919080
Registry record updated May 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OUTPATIENT CLINIC AT PENNEY RETIREMENT COMMUNITY, INC.
Practice address
2 North Pavilion Place
Penney Farms, FL 32079
Phone
(904) 531-7022
NPI assigned
May 13, 2016
Last updated
May 13, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
PENNEY RETIREMENT COMMUNITY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 13, 2016

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

Authorized official

Name
Teresa Scott
Title
President
Phone
(904) 531-7022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

2 North Pavilion Place
Penney Farms, FL 32079

Mailing address

2 North Pavilion Place
Penney Farms, FL 32079
Phone (904) 531-7022

National Provider Directory

National Provider Directory
Tax ID family
Penney Retirement Community3 organizations share this tax ID, including this one
Part of
Penney Retirement Community

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1463097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463097600000",
    "number": "1578919080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 NORTH PAVILION PLACE",
            "city": "PENNEY FARMS",
            "state": "FL",
            "postal_code": "32079",
            "telephone_number": "904-531-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 NORTH PAVILION PLACE",
            "city": "PENNEY FARMS",
            "state": "FL",
            "postal_code": "32079",
            "telephone_number": "904-531-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTPATIENT CLINIC AT PENNEY RETIREMENT COMMUNITY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PENNEY RETIREMENT COMMUNITY, INC.",
        "enumeration_date": "2016-05-13",
        "last_updated": "2016-05-13",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-531-7022"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penney Farms, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; 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.