NPIMap

Organization Active NPI

Medfast Urgent Care Centers, LLC

  • Urgent Care Clinic/Center
  • Melbourne, FL
National Provider Identifier
1861038283
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MEDFAST URGENT CARE CENTERS, LLC
Practice address
5500 Stadium Parkway
Melbourne, FL 32940
Phone
(321) 633-3278
NPI assigned
Nov 20, 2019
Last updated
Dec 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Authorized official

Name
Marilyn Stevens
Title
Billing Director
Phone
(321) 751-7222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

5500 Stadium Parkway
Melbourne, FL 32940

Mailing address

390 N Courtenay Pkwy
Merritt Island, FL 32953-3456
Phone (321) 633-3162

Other identifiers 1

IdentifierTypeStateIssuer
0S6588OtherLICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL info@medfastcare.com

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2177298Medfast Urgent Care Centers LLC5500 Stadium Parkway, Melbourne, FL 32940Certificate of waiverJan 7, 2028

National Provider Directory

National Provider Directory
Tax ID family
Medfast Urgent Care Centers LLC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Locations

5500 Stadium Pkwy
Ste 101
Melbourne, FL 32940
Phone (321) 306-5510

5500 Stadium Pkwy
Viera, FL 32940

Practitioners & affiliated clinicians

Practitioners 3

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": "1574208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1861038283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 N COURTENAY PKWY",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533456",
            "telephone_number": "321-633-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 STADIUM PARKWAY",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32940",
            "telephone_number": "321-633-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFAST URGENT CARE CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-20",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "321-751-7222"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0S6588",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "info@medfastcare.com",
            "affiliation": "N",
            "address_1": "5500 Stadium Parkway",
            "city": "Melbourne",
            "state": "FL",
            "country_code": "US",
            "postal_code": "32940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.