NPIMap

Organization Active NPI

Starke Family Medical Center Inc

Doing business as Village Doctors

  • General Practice Physician
  • Keystone Heights, FL
National Provider Identifier
1780348094
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
STARKE FAMILY MEDICAL CENTER INC
Doing business as
Village Doctors
Practice address
100 S Lawrence Blvd
Keystone Heights, FL 32656-9215
Phone
(352) 473-9373
NPI assigned
Oct 25, 2021
Organization subpart
Yes
Parent organization
STARKE FAMILY MEDICAL CENTER, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Authorized official

Name
Michele Denise Bazile
Title
Director
Phone
(904) 964-5455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

100 S Lawrence Blvd
Keystone Heights, FL 32656-9215

Mailing address

345 W Madison St
Starke, FL 32091-3923
Phone (904) 964-5455

Other names 1

  • Village Doctors Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Starke Family Med Center4 organizations share this tax ID, including this one
Part of
Starke Family Med Center

Other organizations with this tax ID 3

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1780348094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 W MADISON ST",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320913923",
            "telephone_number": "904-964-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S LAWRENCE BLVD",
            "city": "KEYSTONE HEIGHTS",
            "state": "FL",
            "postal_code": "326569215",
            "telephone_number": "352-473-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARKE FAMILY MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STARKE FAMILY MEDICAL CENTER, INC.",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-06",
        "status": "A",
        "authorized_official_last_name": "BAZILE",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-964-5455"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Doctors",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Keystone Heights, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.