Organization Active NPI

Florida Medical Practice Plan Inc

  • Pediatrics Physician
  • Tallahassee, FL
National Provider Identifier
1629947346
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
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 INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X
Genetic Counselor (M.S.)Group: 193200000X MULTI-SPECIALTY GROUP 170300000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 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
10D2341544Florida Medical Practice Plan, Inc2390 Phillips Road, Tallahassee, FL 32308Certificate of waiverApr 2, 2028

National Provider Directory

National Provider Directory
Tax ID family
Florida Medial Practice Plan3 organizations share this tax ID, including this one
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.

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.

Verify at the official NPI Registry.