Sicknwell Medical Group, PA

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SICKNWELL MEDICAL GROUP, PA

Practice address

6405 W Gulf to Lake Hwy
Crystal River, FL 34429-9354

Phone

(352) 527-6888

Fax

(352) 527-8818

NPI assigned

Aug 16, 2018

Organization subpart

No

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

Authorized official

Name

Dacelin St Martin, MD

Title

Medical Director / Owner

Phone

(352) 563-0935

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1760962005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2066",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344602066",
            "telephone_number": "352-563-0931",
            "fax_number": "352-563-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 W GULF TO LAKE HWY",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344299354",
            "telephone_number": "352-527-6888",
            "fax_number": "352-527-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SICKNWELL MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "ST MARTIN",
        "authorized_official_first_name": "DACELIN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR / OWNER",
        "authorized_official_telephone_number": "352-563-0935",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor Shaver
• Raymond Shepherd, PTA
• Stephanie Delois Sheppard, D.C.C
• Trupti S. Shinde, M.D.
• Mujib Shuayb
• Anthony Signoretti, PT, DPT
• Heather Signoretti, PHYSICAL THERAPIST
• Christy Lynn Sims
• Janet K Slawinski, CNP
• John James Slocum

• Multi-Specialty Clinic/Center in Crystal River, FL
• Providers in Crystal River, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.