The Clinic at Walmart Operated by Wuesthoff Health System, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

THE CLINIC AT WALMART OPERATED BY WUESTHOFF HEALTH SYSTEM, LLC

Practice address

1500 E Merritt Island Cswy
Merritt Island, FL 32952-2612

Phone

(321) 449-4534

Fax

(321) 449-4164

NPI assigned

Oct 8, 2009

Organization subpart

Yes

Parent organization

WUESTHOFF FAMILY PHYSICIANS INCAs reported in NPPES

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

Authorized official

Name

Dawn Smitte

Title

Office Assistant WFP

Phone

(321) 449-4534

Specialties & licenses 1

Addresses

Other names 1

• CLINIC AT WALMART Doing business as

Part of

Wuesthoff Family Physicians Inc

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Wuesthoff Family Physicians, Inc

  • General Practice Physician
  • Rockledge, FL
  • NPI 1720092000
  NPPES parent name

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

{
    "created_epoch": "1254960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254960000000",
    "number": "1639404643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N SYKES CREEK PKWY",
            "address_2": "SUITE 300",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533488",
            "telephone_number": "321-449-4534",
            "fax_number": "321-449-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MERRITT ISLAND CSWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329522612",
            "telephone_number": "321-449-4534",
            "fax_number": "321-449-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CLINIC AT WALMART OPERATED BY WUESTHOFF HEALTH SYSTEM, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WUESTHOFF FAMILY PHYSICIANS INC",
        "enumeration_date": "2009-10-08",
        "last_updated": "2009-10-08",
        "status": "A",
        "authorized_official_last_name": "SMITTE",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OFFICE ASSISTANT  WFP",
        "authorized_official_telephone_number": "321-449-4534"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLINIC AT WALMART",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; 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.