NPIMap

Organization Active NPI

Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Titusville, FL
National Provider Identifier
1740606276
Registry record updated Jul 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MEDFAST URGENT CARE CENTERS, LLC
Practice address
3045 Columbia Blvd Ste A108
Titusville, FL 32780-7864
Phone
(321) 633-3278
NPI assigned
Mar 7, 2014
Last updated
Jul 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2021

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

Authorized official

Name
Dr. David Thomas Williams, D.O.NPI 1760484034
Title
Medical Director
Phone
(321) 264-9176

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X FL Primary

Addresses

Primary practice location

3045 Columbia Blvd Ste A108
Titusville, FL 32780-7864

Mailing address

3045 Columbia Blvd Ste 108a
Titusville, FL 32780-7864

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
10D2076689Medfast Urgent Care Centers LLC3045 Columbia Blvd Unit 108a, Titusville, FL 32780Certificate of waiverApr 23, 2028

National Provider Directory

National Provider Directory
Tax ID family
Medfast Urgent Care Centers LLC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Locations

3045 Columbia Blvd
Ste 108A
Titusville, FL 32780
Phone (321) 264-9176

3045 Columbia Blvd
Ste A108
Titusville, FL 32780
Phone (321) 264-9176

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1394150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626134400000",
    "number": "1740606276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3045 COLUMBIA BLVD STE 108A",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327807864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3045 COLUMBIA BLVD STE A108",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327807864",
            "telephone_number": "321-633-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFAST URGENT CARE CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-07",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "321-264-9176",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.