NPIMap

Organization Active NPI

Caremed Clinic LLC

  • Clinical Psychologist
  • Marianna, FL
National Provider Identifier
1760122287
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
CAREMED CLINIC LLC
Practice address
4719 Highway 90
Marianna, FL 32446-7839
Phone
(850) 526-3314
Fax
(850) 526-5022
NPI assigned
Mar 31, 2022
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Amy Dematteo
Title
Credentialing Manager
Phone
(330) 758-2775

Corporate family (same tax ID) 3

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

Practitioners 1

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

National Provider Directory

National Provider Directory
Tax ID family
Caremed Clinic LLC (4 organizations share this tax ID)

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X

Addresses

NPPES NPI Registry

Primary practice location

4719 Highway 90
Marianna, FL 32446-7839

Mailing address

PO Box 14397
Poland, OH 44514-7397
Phone (330) 758-2775

Other practice location 1

951 Prim Ave Ste 20
Graceville, FL 32440-2500
Phone (850) 360-4000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 31, 2022.

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1760122287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14397",
            "city": "POLAND",
            "state": "OH",
            "postal_code": "445147397",
            "telephone_number": "330-758-2775",
            "fax_number": "330-758-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4719 HIGHWAY 90",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324467839",
            "telephone_number": "850-526-3314",
            "fax_number": "850-526-5022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "951 Prim Ave Ste 20",
            "address_purpose": "LOCATION",
            "city": "Graceville",
            "state": "FL",
            "postal_code": "324402500",
            "country_code": "US",
            "telephone_number": "850-360-4000",
            "fax_number": "850-759-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAREMED CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-21",
        "status": "A",
        "authorized_official_last_name": "DEMATTEO",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "330-758-2775"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marianna, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.