Organization Active NPI

Community Hospital Family Practice LLC

  • Surgery Physician
  • Brooksville, FL
National Provider Identifier
1639831449
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
COMMUNITY HOSPITAL FAMILY PRACTICE LLC
Practice address
11371 Cortez Blvd Ste 115
Brooksville, FL 34613-5408
Phone
(352) 592-0220
NPI assigned
Oct 8, 2021
Last updated
Oct 8, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HOSPITAL FAMILY PRACTICE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

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

Authorized official

Name
William Tedrick Johnson
Title
Vice President
Phone
(615) 372-3375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

11371 Cortez Blvd Ste 115
Brooksville, FL 34613-5408

Mailing address

2000 Health Park Dr
Brentwood, TN 37027-4692
Phone (615) 372-5426

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
10D2095704Community Hospital Family Practice LLC11371 Cortez Blvd Ste #223, Brooksville, FL 34613Certificate of waiverMay 10, 2027

National Provider Directory

National Provider Directory
Part of
Community Hospital Family Practice LLC

Ownership & related parties

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.

NPI Registry JSON

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633651200000",
    "number": "1639831449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274692",
            "telephone_number": "615-372-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11371 CORTEZ BLVD STE 115",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135408",
            "telephone_number": "352-592-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPITAL FAMILY PRACTICE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HOSPITAL FAMILY PRACTICE LLC",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TEDRICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-372-3375"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; 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.