Organization Active NPI

Colony Springs Medical Center, Inc

  • Specialist
  • Tamarac, FL
National Provider Identifier
1669690541
Registry record updated Nov 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
COLONY SPRINGS MEDICAL CENTER, INC
Practice address
7737 N University Dr
107
Tamarac, FL 33321-2961
Phone
(954) 720-0056
Fax
(954) 721-4120
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2010

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

Authorized official

Name
Mrs. Claudia Johanna Neira
Title
Managing Director
Phone
(954) 726-3721

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

7737 N University Dr
107
Tamarac, FL 33321-2961

Mailing address

7737 N University Dr
107
Tamarac, FL 33321-2961
Phone (954) 720-0056

Other identifiers 1

IdentifierTypeStateIssuer
051532900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040105000681 FL Part B Supplier - Clinic/Group Practice 5698674075 Receives reassigned benefits from 4 practitioners
Practice locations: Tamarac, FL

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
10D2059161Colony Springs Medical Center Inc7737 N University Dr Ste 107, Tamarac, FL 33321Certificate of waiverMay 19, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1669690541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7737 N UNIVERSITY DR",
            "address_2": "107",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212961",
            "telephone_number": "954-720-0056",
            "fax_number": "954-721-4120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7737 N UNIVERSITY DR",
            "address_2": "107",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333212961",
            "telephone_number": "954-720-0056",
            "fax_number": "954-721-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONY SPRINGS MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "NEIRA",
        "authorized_official_first_name": "CLAUDIA",
        "authorized_official_middle_name": "JOHANNA",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "954-726-3721",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051532900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.