South Titusville Medical Center Inc

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

ME0051997 Issued in FL

Legal business name

SOUTH TITUSVILLE MEDICAL CENTER INC

Practice address

7455 S US Highway 1
Titusville, FL 32780-8115

Phone

(321) 264-2100

Fax

(321) 264-2485

NPI assigned

Jun 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Charles A Slattery, M.D.NPI 1821291048

Title

Owner/Ceo

Phone

(321) 264-2100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles A Slattery, MD

  • Internal Medicine Physician
  • Titusville, FL
  • NPI 1821291048
  Medicare reassignment NPD Authorized official
• Mary Rachael Hutchison, FNP-C

  • Family Nurse Practitioner
  • Titusville, FL
  • NPI 1225650898
  Medicare reassignment NPD
• Janis Elaine Oenbrink, FNP-C

  • Family Nurse Practitioner
  • Cocoa, FL
  • NPI 1871132597
  Medicare reassignment NPD
• Stephanie Ranallo, APRN

  • Family Medicine Physician
  • Rockledge, FL
  • NPI 1255022471
  NPD (past)

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413936000000",
    "number": "1821031683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7455 S US HIGHWAY 1",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327808115",
            "telephone_number": "321-264-2100",
            "fax_number": "321-264-2485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7455 S US HIGHWAY 1",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327808115",
            "telephone_number": "321-264-2100",
            "fax_number": "321-264-2485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TITUSVILLE MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2014-10-22",
        "status": "A",
        "authorized_official_last_name": "SLATTERY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "321-264-2100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "FL",
            "license": "ME0051997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062108100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Louis Smith, D.C.
• Jaime Brooke Smyth
• Mohamed Aly Soliman
• Michael Sorbello, DO
• Renee Lok-Yee Wong Soucier, MD
• Southern Living of Titusville
• Sovereign Healthcare of Titusville, LLC
• Space Coast Assisted Living LLC
• Space Coast Health Centers Inc
• Space Coast Medical Associates LLP

• Health Service Clinic/Center in Titusville, FL
• Providers in Titusville, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.