NPIMap

Organization Active NPI

Caremed Clinic LLC

  • Internal Medicine Physician
  • Graceville, FL
National Provider Identifier
1871199760
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CAREMED CLINIC LLC
Practice address
951 Prim Ave Ste 20
Graceville, FL 32440-2500
Phone
(850) 526-3314
NPI assigned
Dec 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Authorized official

Name
Amy Dematteo
Title
Credentialing Specialist
Phone
(330) 758-2775

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

951 Prim Ave Ste 20
Graceville, FL 32440-2500

Mailing address

4719 Highway 90
Marianna, FL 32446-7839
Phone (850) 526-3314

National Provider Directory

National Provider Directory
Tax ID family
Caremed Clinic LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1871199760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4719 HIGHWAY 90",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324467839",
            "telephone_number": "850-526-3314",
            "fax_number": "850-526-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 PRIM AVE STE 20",
            "city": "GRACEVILLE",
            "state": "FL",
            "postal_code": "324402500",
            "telephone_number": "850-526-3314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREMED CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "DEMATTEO",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "330-758-2775"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Graceville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.