NPIMap

Organization Active NPI

Seminole Tribe of Florida Health Department

  • Primary Care Clinic/Center
  • Okeechobee, FL
National Provider Identifier
1750610325
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SEMINOLE TRIBE OF FLORIDA HEALTH DEPARTMENT
Practice address
17201 Civic St. NE
Okeechobee, FL 34974-2729
Phone
(863) 763-0271
Fax
(863) 763-9698
NPI assigned
Dec 10, 2009
Last updated
Jan 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Authorized official

Name
Connie Whidden, MSW
Title
Health Director Seminole Tribe of F
Phone
(954) 962-2009

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federal Public Health Clinic/Center 261QP0904X 1182592 FL
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

17201 Civic St. NE
Okeechobee, FL 34974-2729

Mailing address

17201 Civic St NE
Okeechobee, FL 34974-2729
Phone (863) 763-0271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20101130000352 FL Part B Supplier - Clinic/Group Practice 2769580539 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clewiston, FL; Hollywood, FL; Okeechobee, FL; Palm Springs, FL
O20210817002167 TX Part B Supplier - Clinic/Group Practice 4082710835 Receives reassigned benefits from 15 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Clewiston, FL; Hollywood, FL; Immokalee, FL; Okeechobee, FL

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Seminole Tribe of Florida9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

111 W Coral Way
Hollywood, FL 33021
Phone (954) 962-2009

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 6

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": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327276800000",
    "number": "1750610325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17201 CIVIC ST NE",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349742729",
            "telephone_number": "863-763-0271",
            "fax_number": "863-763-9698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17201 CIVIC ST. NE",
            "city": "OKEECHOBEE",
            "state": "FL",
            "postal_code": "349742729",
            "telephone_number": "863-763-0271",
            "fax_number": "863-763-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEMINOLE TRIBE OF FLORIDA HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2012-01-23",
        "status": "A",
        "authorized_official_last_name": "WHIDDEN",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_title_or_position": "HEALTH DIRECTOR SEMINOLE TRIBE OF F",
        "authorized_official_telephone_number": "954-962-2009",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "261QP0904X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, Federal",
            "state": "FL",
            "license": "1182592",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okeechobee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.