NPIMap

Organization Active NPI

Dwic of Tampa Bay, Inc

  • Urgent Care Clinic/Center
  • North Port, FL
National Provider Identifier
1871941815
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
DWIC OF TAMPA BAY, INC
Practice address
5616 Tuscola Blvd
North Port, FL 34287-2738
Phone
(941) 240-6273
Fax
(941) 240-6428
NPI assigned
Jun 1, 2016
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Joy Kimball
Title
Contract Manager
Phone
(763) 349-6740

Other NPIs on the same Medicare enrollment 22

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 22

Practitioners 6

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040517001035 FL Part B Supplier - Clinic/Group Practice 3779573167 Receives reassigned benefits from 129 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lutz, FL; Vero Beach, FL; Tampa, FL; Port Charlotte, FL; North Port, FL; Naples, FL; Lehigh Acres, FL; Largo, FL…

National Provider Directory

National Provider Directory

Locations

5616 Tuscola Blvd
North Port, FL 34287
Phone (941) 240-6273

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

NPPES NPI Registry

Primary practice location

5616 Tuscola Blvd
North Port, FL 34287-2738

Mailing address

423 Fortress Blvd
Morgantown, WV 26508-1351
Phone (304) 225-2500

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
018546900MedicaidFL

Other names 1

NPPES NPI Registry
  • MedExpress Urgent Care - North Port, Tuscola Blvd Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 7, 2024.

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1871941815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 FORTRESS BLVD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081351",
            "telephone_number": "304-225-2500",
            "fax_number": "304-985-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5616 TUSCOLA BLVD",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342872738",
            "telephone_number": "941-240-6273",
            "fax_number": "941-240-6428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DWIC OF TAMPA BAY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-01",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "JOY",
        "authorized_official_title_or_position": "CONTRACT MANAGER",
        "authorized_official_telephone_number": "763-349-6740"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018546900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedExpress Urgent Care - North Port, Tuscola Blvd",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Port, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.