NPIMap

Organization Active NPI

1St Choice Urgent Care Center LLC

  • Urgent Care Clinic/Center
  • Newberry, FL
National Provider Identifier
1760825699
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
1ST CHOICE URGENT CARE CENTER LLC
Practice address
128 NW 137TH Drive
Newberry, FL 32669
Phone
(352) 332-1890
Fax
(352) 224-6465
NPI assigned
Apr 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
John Distefano
Title
Owner
Phone
(352) 317-3214

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

128 NW 137TH Drive
Newberry, FL 32669

Mailing address

10348 SW 32ND Ave
Gainesville, FL 32608-9096
Phone (352) 317-3214

Other practice location 1

817 NW 56th Ter Ste B
Gainesville, FL 32605-6401
Phone (352) 352-3360

Other practice location 2

275 W Main St
Lake Butler, FL 32054-1656
Phone (386) 496-2273

Other identifiers 1

IdentifierTypeStateIssuer
HE751AOtherMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130529000307 FL Part B Supplier - Clinic/Group Practice 8224276571 Receives reassigned benefits from 1 practitioner
2 other NPIs on this enrollment
Practice locations: Lake Butler, FL; Newberry, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 4

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

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1365552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1760825699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10348 SW 32ND AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326089096",
            "telephone_number": "352-317-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 NW 137TH DRIVE",
            "city": "NEWBERRY",
            "state": "FL",
            "postal_code": "32669",
            "telephone_number": "352-332-1890",
            "fax_number": "352-224-6465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "817 NW 56th Ter Ste B",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326056401",
            "country_code": "US",
            "telephone_number": "352-352-3360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "275 W Main St",
            "address_purpose": "LOCATION",
            "city": "Lake Butler",
            "state": "FL",
            "postal_code": "320541656",
            "country_code": "US",
            "telephone_number": "386-496-2273",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "1ST CHOICE URGENT CARE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-10",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "DISTEFANO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-317-3214"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "HE751A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberry, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.