Active NPI
Florida Medical Practice Plan Inc
- Pediatrics Physician
- Tallahassee, FL
National Provider Identifier
1629947346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- FLORIDA MEDICAL PRACTICE PLAN INC
- Practice address
- 2390 Phillips Rd
Tallahassee, FL 32308-5326 - Phone
- (850) 645-9451
- NPI assigned
- Oct 31, 2025
- Organization subpart
- Yes
- Parent organization
- FLORIDA MEDICAL PRACTICE PLAN INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Patricia Ballantine
- Title
- Head of Clinical Operations
- Phone
- (850) 645-9451
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | |||
| Genetic Counselor (M.S.) | 170300000X | |||
| Internal Medicine Physician | 207R00000X | |||
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | |||
| Pediatrics Physician | 208000000X | Primary | ||
| Psychiatry Physician | 2084P0800X |
Addresses
Primary practice location
2390 Phillips Rd
Tallahassee, FL 32308-5326
Mailing address
2390 Phillips Rd
Tallahassee, FL 32308-5326
Phone (850) 645-9451
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2341544 | Florida Medical Practice Plan, Inc | Certificate of waiver | Apr 2, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- Florida Medial Practice Plan
- Part of
- Florida Medial Practice Plan
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Psychiatry Physician
- Tallahassee, FL
- NPI 1710685615
-
- General Practice Physician
- Tallahassee, FL
- NPI 1528631454
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761868800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1773100800000",
"number": "1629947346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2390 PHILLIPS RD",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323085326",
"telephone_number": "850-645-9451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2390 PHILLIPS RD",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323085326",
"telephone_number": "850-645-9451"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FLORIDA MEDICAL PRACTICE PLAN INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FLORIDA MEDICAL PRACTICE PLAN INC",
"enumeration_date": "2025-10-31",
"last_updated": "2026-03-10",
"certification_date": "2026-03-10",
"status": "A",
"authorized_official_last_name": "BALLANTINE",
"authorized_official_first_name": "PATRICIA",
"authorized_official_title_or_position": "HEAD OF CLINICAL OPERATIONS",
"authorized_official_telephone_number": "850-645-9451"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Clinical Neuropsychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "170300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Genetic Counselor, MS",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RG0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2026; 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.