Ultimate Medical Clinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ULTIMATE MEDICAL CLINIC LLC

Practice address

70 Fox Ridge CT Ste a
Debary, FL 32713-2752

Phone

(386) 668-6321

NPI assigned

Mar 1, 2021

Last updated

Mar 1, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

DEBARY CHIROPRACTIC CENTER CORPAs reported in NPPES

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

Authorized official

Name

Jamie Grainger, DCNPI 1194259226

Title

Owner/Chiropractor

Phone

(386) 668-6321

Specialties & licenses 1

Addresses

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

Part of

Debary Chiropractic Center Corp

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Debary Chiropractic Center Corp

  • Chiropractor
  • Debary, FL
  • NPI 1255853461

  Member Of

  NPD member

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Debary Chiropractic Center Corp

  • Chiropractor
  • Debary, FL
  • NPI 1255853461
  NPPES parent name

Practitioners 4

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.

• Jennifer Kaufmann, APRN

  • Family Nurse Practitioner
  • Debary, FL
  • NPI 1073197281
  Medicare reassignment NPD
• Meganne Mannon, ARNP

  • Family Nurse Practitioner
  • Oviedo, FL
  • NPI 1295472090

  Multi-Specialty

  Medicare reassignment NPD
• Jamie Grainger, D.C.

  • Chiropractor
  • Debary, FL
  • NPI 1194259226
  NPD Authorized official
• Lauren Anne Eggnatz, APRN

  • Family Medicine Physician
  • Orange City, FL
  • NPI 1497360481
  NPD

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1922692003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 FOX RIDGE CT STE A",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132752",
            "telephone_number": "386-668-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 FOX RIDGE CT STE A",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132752",
            "telephone_number": "386-668-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ULTIMATE MEDICAL CLINIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEBARY CHIROPRACTIC CENTER CORP",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "GRAINGER",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "386-668-6321",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Together in Health, Inc
• Total Vision PA
• Anthony Joseph Tucker, PA-C
• Rebecca Jane Tulloch, MSW, RCSWI
• Orly Tyrkala, PHARM. D.
• Rosendo De Jesus Urena, APRN
• Wanda Kay Vasquez, OT
• Nicole Teresa Velazquez, RBT
• Aimee Elizabeth Velez, RBT
• Carmen Adela Viera, M.S.

• Primary Care Clinic/Center in Debary, FL
• Providers in Debary, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.