Organization Active NPI

North Florida Primary Care PLLC

  • Internal Medicine Physician
  • Lake City, FL
National Provider Identifier
1760093702
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
NORTH FLORIDA PRIMARY CARE PLLC
Practice address
4243 SW Cambridge GLN
Lake City, FL 32024-3431
Phone
(386) 292-7744
Fax
(386) 719-7096
NPI assigned
Aug 13, 2020
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Michael C Ukaegbu Sr., MDNPI 1427254283
Title
Owner
Phone
(386) 697-4973

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

Practitioners 2

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

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
10D2200577North Florida Primary Care, PLLC4243 SW Cambridge Glen, Lake City, FL 32024Certificate of waiverNov 15, 2026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20201209001242 FL Part B Supplier - Clinic/Group Practice 3678985017 Receives reassigned benefits from 2 practitioners
Practice locations: Lake City, FL

National Provider Directory

National Provider Directory

Locations

4243 SW Cambridge Gln
Lake City, FL 32024
Phone (386) 292-7744

221 SW Stonegate Ter
Ste 101
Lake City, FL 32024
Phone (386) 292-7744

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22132/brand/1/csg/1/fhir/r4

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

4243 SW Cambridge GLN
Lake City, FL 32024-3431

Mailing address

4243 SW Cambridge GLN
Lake City, FL 32024-3431
Phone (386) 292-7744

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
010767000MedicaidFL

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Other URL Athenahealth.com/solutions/patient-engagement Health Information Exchange (HIE)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 6, 2025.

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1760093702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4243 SW CAMBRIDGE GLN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320243431",
            "telephone_number": "386-292-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4243 SW CAMBRIDGE GLN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320243431",
            "telephone_number": "386-292-7744",
            "fax_number": "386-719-7096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FLORIDA PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-13",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "UKAEGBU",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-697-4973",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010767000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Athenahealth.com/solutions/patient-engagement",
            "affiliation": "N",
            "endpointDescription": "Portal",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Pdf",
            "address_1": "221 SW Stonegate Ter Ste 101",
            "city": "Lake City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320243463",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; 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.