Waymaker NP Care LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

WAYMAKER NP CARE LLC

Practice address

1700 Ridgewood Ave Ste H
Holly Hill, FL 32117-1782

Phone

(386) 882-0063

Fax

(386) 281-3370

NPI assigned

Feb 8, 2021

Organization subpart

No

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

Authorized official

Name

Angela Marie Moodie, APRN

Title

Manager/ Owner

Phone

(386) 882-0063

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1612742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1699367011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 REDWOOD ST",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321174571",
            "telephone_number": "386-882-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 RIDGEWOOD AVE STE H",
            "city": "HOLLY HILL",
            "state": "FL",
            "postal_code": "321171782",
            "telephone_number": "386-882-0063",
            "fax_number": "386-281-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYMAKER NP CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-08",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "MOODIE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "MANAGER/ OWNER",
        "authorized_official_telephone_number": "386-882-0063",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Holly Hill, FL
• Providers in Holly Hill, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.