NPIMap

Individual provider Active NPI

Celeste Michelle Vickery, D.O.

  • Family Medicine Physician
  • Orange City, FL
National Provider Identifier
1780211821
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS19786 Issued in FL
Practice address
1061 Medical Center Dr Ste 102
Orange City, FL 32763-8225
Phone
(386) 917-7668
Fax
(386) 456-1206
NPI assigned
Mar 26, 2020
Last updated
Sep 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS19786 FL Primary

Addresses

Primary practice location

1061 Medical Center Dr Ste 102
Orange City, FL 32763-8225

Mailing address

1061 Medical Center Dr Ste 102
Orange City, FL 32763-8225
Phone (386) 917-7668

Other names 1

  • Celeste Boor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230804001426 FL Practitioner - Family Practice 8426470931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie Col of Osteo Med at Seton Hill Univ, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Adventhealth Primary Care Network IncGroup PAC ID 1557722410, 428 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

1745 Sterling Silver Blvd
Deltona, FL 32725-4332

661 E Altamonte Dr
Suite 115
Altamonte Springs, FL 32701-5102
Phone (407) 831-4040

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS19786FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adventhealth Primary Care Network Inc Family Medicine CurrentSince Nov 1, 2023 Accepting new patients

Locations

661 E Altamonte Dr
Ste 115
Altamonte Springs, FL 32701
Phone (407) 831-4040

1745 Sterling Silver Blvd
Ste 102
Deltona, FL 32725
Phone (386) 917-7668

1061 Medical Center Dr
Ste 102
Orange City, FL 32763
Phone (386) 456-3852

Interoperability endpoints

  • Direct secure messaging: cvickery1615291@adventhealth.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1780211821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 MEDICAL CENTER DR STE 102",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638225",
            "telephone_number": "386-917-7668",
            "fax_number": "386-456-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 MEDICAL CENTER DR STE 102",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638225",
            "telephone_number": "386-917-7668",
            "fax_number": "386-456-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERY",
        "first_name": "CELESTE",
        "middle_name": "MICHELLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS19786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CELESTE",
            "last_name": "BOOR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.