NPIMap

Organization Active NPI

District Clinic Holdings Inc

Doing business as C. L. Brumback Primary Care Clinics-Dental

  • Federally Qualified Health Center (FQHC)
  • Belle Glade, FL
National Provider Identifier
1720474075
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
DISTRICT CLINIC HOLDINGS INC
Doing business as
C. L. Brumback Primary Care Clinics-Dental
Practice address
39200 Hooker Hwy Ste 101
Belle Glade, FL 33430-5368
Phone
(561) 642-1000
NPI assigned
Apr 14, 2015
Last updated
Sep 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Authorized official

Name
Darcy Davis
Title
Ceo
Phone
(561) 804-5885

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X
Federally Qualified Health Center (FQHC) 261QF0400X FL Primary

Addresses

Primary practice location

39200 Hooker Hwy Ste 101
Belle Glade, FL 33430-5368

Mailing address

1515 N Flagler Dr Ste 101
West Palm Beach, FL 33401-3429
Phone (561) 659-1270

Other identifiers 2

IdentifierTypeStateIssuer
008037114MedicaidFL
008037115MedicaidFL

Other names 1

  • C. L. Brumback Primary Care Clinics-Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
District Clinic Holdings Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

39200 Hooker Hwy
Ste 101
Belle Glade, FL 33430
Phone (561) 209-2580

NPI Registry JSON

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

{
    "created_epoch": "1428969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632182400000",
    "number": "1720474075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 N FLAGLER DR STE 101",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334013429",
            "telephone_number": "561-659-1270",
            "fax_number": "561-802-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39200 HOOKER HWY STE 101",
            "city": "BELLE GLADE",
            "state": "FL",
            "postal_code": "334305368",
            "telephone_number": "561-642-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTRICT CLINIC HOLDINGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-14",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "DARCY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-804-5885"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008037114",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008037115",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "C. L. Brumback Primary Care Clinics-Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Belle Glade, FL

Sources for this page

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