Emory Medical Corporation

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

EMORY MEDICAL CORPORATION

Practice address

4812 W US Highway 90
Lake City, FL 32055-5126

Phone

(386) 466-1106

Fax

(386) 466-1821

NPI assigned

Jun 24, 2008

Organization subpart

No

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

Authorized official

Name

Chandler Mohan, MDNPI 1629239561

Title

Managing Member

Phone

(386) 466-1106

Specialties & licenses 3

Addresses

Other identifiers 1

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

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Emory Medical Corporation

  dba Women's Center of Florida

  • Specialist
  • Starke, FL
  • NPI 1033542485
  NPPES parent name

Practitioners 2

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

• Chandler Vimal Mohan, M.D.

  • Gynecology Physician
  • Lake City, FL
  • NPI 1629239561

  General Practice

  Medicare reassignment NPD Authorized official
• Natascha Katovich, LCSW

  • Clinical Social Worker
  • Lake City, FL
  • NPI 1699421560
  NPD (past)

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

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583280000000",
    "number": "1598926263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1646",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320561646",
            "telephone_number": "386-466-1106",
            "fax_number": "386-466-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 W US HIGHWAY 90",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320555126",
            "telephone_number": "386-466-1106",
            "fax_number": "386-466-1821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMORY MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-24",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A",
        "authorized_official_last_name": "MOHAN",
        "authorized_official_first_name": "CHANDLER",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "386-466-1106",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101243179",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101243179",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598926263",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Ellis, FNP
• Octavia Ellison, CRC, CTRS
• Helen Emery, DPT
• Ryan Emilio, LMSW
• Elijah Curtiss Emond
• Lisa K Engels, RD
• Hannah Engle
• Michael R Engle, RKT
• Enrique Technologies Inc
• Hannah Ogechi Ephraim, MD

• Obstetrics & Gynecology Physician in Lake City, FL
• Providers in Lake City, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.