Organization Active NPI

Town Center Family Medicine LLC

Doing business as Town Center Medical

  • Family Medicine Physician
  • Celebration, FL
National Provider Identifier
1790047934
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TOWN CENTER FAMILY MEDICINE LLC
Doing business as
Town Center Medical
Practice address
610 Sycamore St
Suite 130
Celebration, FL 34747-4995
Phone
(386) 788-6616
NPI assigned
Jun 13, 2012
Last updated
Mar 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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

Authorized official

Name
Chad Black
Title
Owner/Partner
Phone
(386) 788-6616

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Non-Pharmacy Dispensing Site 332900000X ME100993 FL

Addresses

Primary practice location

610 Sycamore St
Suite 130
Celebration, FL 34747-4995

Mailing address

610 Sycamore St
Suite 130
Celebration, FL 34747-4995
Phone (386) 788-6616

Other names 1

  • Town Center Medical Doing business as

National Provider Directory

National Provider Directory

Locations

610 Sycamore St
Ste 130
Kissimmee, FL 34747
Phone (407) 567-7802

Ownership & related parties

Subparts reporting this organization as parent 1

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

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1790047934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 SYCAMORE ST",
            "address_2": "SUITE 130",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474995",
            "telephone_number": "386-788-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 SYCAMORE ST",
            "address_2": "SUITE 130",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474995",
            "telephone_number": "386-788-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN CENTER FAMILY MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-13",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "386-788-6616"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "ME100993",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Town Center Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Celebration, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; 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.