CCM Specialists LLC

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

ME105093 Issued in FL

Legal business name

CCM SPECIALISTS LLC

Practice address

1108 Amber Lake CT
Cape Coral, FL 33909

Phone

(425) 270-5432

NPI assigned

Dec 26, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Ajay K Dhawan, MDNPI 1356365043

Title

Medical Director

Phone

(239) 699-5830

Specialties & licenses 1

Addresses

Practitioners 1

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

• Ajay K Dhawan, MD

  • Internal Medicine Physician
  • Cape Coral, FL
  • NPI 1356365043
  NPD (past) Authorized official

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

{
    "created_epoch": "1419552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419552000000",
    "number": "1891183984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 AMBER LAKE CT",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "33909",
            "telephone_number": "425-270-5432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 AMBER LAKE CT",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "33909",
            "telephone_number": "425-270-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CCM SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-26",
        "last_updated": "2014-12-26",
        "status": "A",
        "authorized_official_last_name": "DHAWAN",
        "authorized_official_first_name": "AJAY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "239-699-5830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "ME105093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany J Catinchi Jimenez, DC
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• Tiffany Marie Cavin, DO
• Rachel Cavucci, MA, LMHC
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• Case Manager/Care Coordinator in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Case Manager/Care Coordinator in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2014; 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.