Family Practice of West Volusia Inc

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

OS6029 Issued in FL

Legal business name

FAMILY PRACTICE OF WEST VOLUSIA INC

Doing business as

Family Practice of West Volusia- Deland

Practice address

862 Peachwood Dr
Deland, FL 32720-0834

Phone

(386) 960-2009

NPI assigned

Dec 20, 2013

Organization subpart

Yes

Parent organization

MEDVANTXAs reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

VP of Operations

Phone

(858) 964-1506

Specialties & licenses 1

Addresses

Other names 1

• FAMILY PRACTICE OF WEST VOLUSIA- DELAND Doing business as

Tax ID family

Family Practice of West Volusia Inc2 organizations share this tax ID, including this one

Part of

Tri - State Medical Group Inc

Other organizations with this tax ID 1

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

• Family Practice of West Volusia Inc

  dba Family Practice of West Volusia- Orange City

  • Non-Pharmacy Dispensing Site
  • Orange City, FL
  • NPI 1477972271
  NPD tax ID

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.

• Bruce Glenn Rankin, D. O.

  • Family Medicine Physician
  • Deland, FL
  • NPI 1922027853
  NPD (past)

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387497600000",
    "number": "1760803555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "862 PEACHWOOD DR",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327200834",
            "telephone_number": "386-960-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE OF WEST VOLUSIA INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX",
        "enumeration_date": "2013-12-20",
        "last_updated": "2013-12-20",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "858-964-1506"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "OS6029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY PRACTICE OF WEST VOLUSIA- DELAND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Everwise Nutrition
• Everyday Angels Inc
• Lawanda L Ewing, MSN, CRNP, FNP-BC
• Exquisite Healthcare Professionals LLC
• Latrelle A Fakeye, RPH
• Family Practice of West Volusia, P.a.
• Judson Fann, MS, ATC, LAT, CSCS
• Robert Fechtenburg, CRNA
• Andrew C Feldman, D.O.
• Jacinta F Feldman, CNM

• Non-Pharmacy Dispensing Site in Deland, FL
• Providers in Deland, FL by specialty
• Non-Pharmacy Dispensing Site in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.