Starke Family Medicine Clinic 01 Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0081878 Issued in FL

Legal business name

STARKE FAMILY MEDICINE CLINIC 01 INC

Practice address

1546 S Water St
Starke, FL 32091-4511

Phone

(904) 964-1888

Fax

(904) 964-1884

NPI assigned

Oct 24, 2007

Last updated

Oct 24, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Natalia A Shiriaeva, MDNPI 1518947894

Title

President

Phone

(904) 964-1888

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Natalia Anatolievna Shiriaeva, MD

  • Family Medicine Physician
  • Starke, FL
  • NPI 1518947894
  Authorized official Same address or phone

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1760661938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1546 S WATER ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320914511",
            "telephone_number": "904-964-1888",
            "fax_number": "904-964-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1546 S WATER ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320914511",
            "telephone_number": "904-964-1888",
            "fax_number": "904-964-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARKE FAMILY MEDICINE CLINIC 01 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "SHIRIAEVA",
        "authorized_official_first_name": "NATALIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-964-1888",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0081878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Diane Smith, LMT
• Taylor Soares
• Specialized Treatment, Assessment, & Programming Services, Inc.
• Starke Chiropractic Inc.
• Starke Family Medical Center Inc (immediate care center of starke)
• Starke Family Pharmacy
• Starke Family Pharmacy-LTC (Starke Family Pharmacy)
• Starke Hma LLC (Shands Medical Group of Starke)
• Starke Hma LLC (Shands Starke Regional Medical Center)
• Starke Hma Medical Group LLC

• Family Medicine Physician in Starke, FL
• Providers in Starke, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.