NPIMap

Organization Active NPI

Florida Clinical Practice Association Inc

Doing business as UF Health Family Medicine - Old Town

  • Family Medicine Physician
  • Old Town, FL
National Provider Identifier
1629138292
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FLORIDA CLINICAL PRACTICE ASSOCIATION INC
Doing business as
UF Health Family Medicine - Old Town
Practice address
25827 SE Highway 19
Old Town, FL 32680-3997
Phone
(352) 265-7922
NPI assigned
Dec 12, 2006
Last updated
Dec 28, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2015

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

Authorized official

Name
William W Tharp
Title
Executive Vice President
Phone
(352) 265-8017

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Nurse Practitioner 363L00000X
Family Medicine Physician 207Q00000X Primary
Pediatrics Physician 208000000X

Addresses

Primary practice location

25827 SE Highway 19
Old Town, FL 32680-3997

Mailing address

PO Box 13833
Philadelphia, PA 19101-3833

Other identifiers 1

IdentifierTypeStateIssuer
053386614MedicaidFL

Other names 1

  • UF Health Family Medicine - Old Town Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0895348Uf Health Family Medicine - Old Town25827 SE Highway 19, Old Town, FL 32680Provider-performed microscopyDec 6, 2026

National Provider Directory

National Provider Directory
Tax ID family
Salvatorer Goodwin MD33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451260800000",
    "number": "1629138292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13833",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191013833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25827 SE HIGHWAY 19",
            "city": "OLD TOWN",
            "state": "FL",
            "postal_code": "326803997",
            "telephone_number": "352-265-7922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA CLINICAL PRACTICE ASSOCIATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2015-12-28",
        "status": "A",
        "authorized_official_last_name": "THARP",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "352-265-8017"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053386614",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UF Health Family Medicine - Old Town",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Old Town, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.