Tele Med Clinix LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

TELE MED CLINIX LLC

Practice address

541 N Palmetto Ave Ste 104B
Sanford, FL 32771-1371

Phone

(321) 209-4040

NPI assigned

Apr 23, 2020

Last updated

May 17, 2023By 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

David Knight

Title

Owner

Phone

(917) 635-5234

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, LA2 enrollments

Enrollment records 2

Locations

Practitioners 15

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.

• Nelson Antonio Pichardo, MD

  • Psychiatry Physician
  • Santa Rosa Beach, FL
  • NPI 1649437401

  Multi-Specialty

  Medicare reassignment NPD
• Lynn M Steinhart, LMHC

  • Mental Health Counselor
  • West Palm Beach, FL
  • NPI 1194578997
  Medicare reassignment NPD
• Latara Taylor, FNP-C

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1316573173
  Medicare reassignment NPD
• Brandi Barber Stephens, FNP-C

  • Family Nurse Practitioner
  • Shreveport, LA
  • NPI 1659677540
  Medicare reassignment NPD
• Chequan Michelle Thomas, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bossier City, LA
  • NPI 1821375932

  FL, Single Specialty

  Medicare reassignment NPD
• Catherine Jessica Barton, PA

  • Physician Assistant
  • Kissimmee, FL
  • NPI 1528598067
  Medicare reassignment
• Theresa A Biemer, P.A-C

  • Physician Assistant
  • Port St Lucie, FL
  • NPI 1982716353
  Medicare reassignment
• Ahsan Hamid

  • Physician Assistant
  • Kissimmee, FL
  • NPI 1598187767
  Medicare reassignment
• Jasmine Patino

  • Physician Assistant
  • Coconut Creek, FL
  • NPI 1780173666
  Medicare reassignment
• Jessica D Daigle, PA-C

  • Physician Assistant
  • Youngsville, LA
  • NPI 1821506726
  Medicare reassignment
• Bianca Carroll, NP

  • Family Nurse Practitioner
  • Sanford, FL
  • NPI 1649658030
  NPD
• Jennifer Palumbo, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • Albuquerque, NM
  • NPI 1043802507
  NPD

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684281600000",
    "number": "1780204305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 N PALMETTO AVE STE 104B",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 N PALMETTO AVE STE 104B",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711371",
            "telephone_number": "321-209-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELE MED CLINIX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-23",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-635-5234"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114165800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Killgore Teal, M.S.
• Teamcare Infusion Orlando Inc
• Teamcare Pharmacy Services 3, LLC
• Diane Teasley
• Gabriel Tejeda
• Jamal Tennon
• Nicole Rose Tenore, MSW
• Deja Terry
• Robert Thally
• The Beauty Menagerie LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Sanford, FL
• Providers in Sanford, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; 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.