Fort Pierce Family Care, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME0059609 Issued in FL

Legal business name

FORT PIERCE FAMILY CARE, INC.

Practice address

3851 Virginia Avenue
Fort Pierce, FL 34981

Phone

(954) 661-8151

NPI assigned

May 31, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jerry Jacobson, MD

Title

Physician

Phone

(954) 661-8151

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

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

• Jerome R Jacobson, M.D.

  • General Practice Physician
  • Palatka, FL
  • NPI 1770590168

  FL

  Medicare reassignment NPD
• Kelly Lee Morgado, PA

  • Physician Assistant
  • Vero Beach, FL
  • NPI 1992715072
  NPD
• Tammie Rae Vandenberg

  • Family Nurse Practitioner
  • Fort Pierce, FL
  • NPI 1952094971
  NPD
• Brian Richard Eddy, APRN

  • Gerontology Nurse Practitioner
  • Vero Beach, FL
  • NPI 1780335299
  NPD (past)
• Kimberly Caitlyn Leys, ARNP,FNP-C

  • Family Nurse Practitioner
  • Fort Pierce, FL
  • NPI 1689509655
  NPD (past)
• Melinda Said, PA-C

  • Medical Physician Assistant
  • Port St Lucie, FL
  • NPI 1780574335
  NPD (past)
• Morgan Thomas

  • Psychiatric/Mental Health Nurse Practitioner
  • Deland, FL
  • NPI 1992271134
  NPD (past)
• Nathan Lewis Wade, P.A.

  • Physician Assistant
  • Asheville, NC
  • NPI 1235567116
  NPD (past)

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

{
    "created_epoch": "1306800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306800000000",
    "number": "1710271333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 OAK RIDGE LN",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333313706",
            "telephone_number": "954-661-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 VIRGINIA AVENUE",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "34981",
            "telephone_number": "954-661-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT PIERCE FAMILY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-31",
        "last_updated": "2011-05-31",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "954-661-8151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME0059609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Focused ABA LLC
• Nila Folkes
• Kimberly Ross Foncham Bradley, ARNP
• Forever Loving Hands, Inc
• Fort Pierce Discount Pharmacy, Inc.
• Fort Pierce Health Care Associates LLC
• Fort Pierce Intermediate Care Center
• Fort Pierce Orthopaedics LLC
• Fort Pierce Vision LLC
• Tisa D Forte, RN

• Primary Care Clinic/Center in Fort Pierce, FL
• Providers in Fort Pierce, 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 May 31, 2011; 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.