NPIMap

Organization Active NPI

Family Practice of Davie Inc.

Doing business as Family Medical Center

  • Adult Medicine Physician
  • Pembroke Pines, FL
National Provider Identifier
1932345956
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
ME62781 Issued in FL
Legal business name
FAMILY PRACTICE OF DAVIE INC.
Doing business as
Family Medical Center
Practice address
1150 N University Dr
Pembroke Pines, FL 33024-5031
Phone
(954) 616-2020
Fax
(954) 616-3030
NPI assigned
Dec 22, 2008
Last updated
Jan 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Authorized official

Name
Mr. Joseph C James, APRNNPI 1447310206
Title
President
Phone
(954) 616-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X ME62781 FL Primary

Addresses

Primary practice location

1150 N University Dr
Pembroke Pines, FL 33024-5031

Mailing address

1150 N University Dr
Pembroke Pines, FL 33024-5031
Phone (954) 616-2020

Other practice location 1

5930 SW 64th Ave
Davie, FL 33314-7116
Phone (954) 791-7101

Other names 1

  • Family Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110506000374 FL Part B Supplier - Clinic/Group Practice 5698950640 Receives reassigned benefits from 13 practitioners
Practice locations: Davie, FL; Pembroke Pines, FL

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
10D1089655Family Practice of Davie Inc1150 N University Dr, Pembroke Pines, FL 33024Certificate of waiverSep 22, 2026

National Provider Directory

National Provider Directory

Locations

5669 S University Dr
Davie, FL 33328
Phone (954) 616-2020

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1932345956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 N UNIVERSITY DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330245031",
            "telephone_number": "954-616-2020",
            "fax_number": "954-616-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 N UNIVERSITY DR",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330245031",
            "telephone_number": "954-616-2020",
            "fax_number": "954-616-3030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5930 SW 64th Ave",
            "address_purpose": "LOCATION",
            "city": "Davie",
            "state": "FL",
            "postal_code": "333147116",
            "country_code": "US",
            "telephone_number": "954-791-7101",
            "fax_number": "954-791-2521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAMILY PRACTICE OF DAVIE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-22",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-616-2020",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ME62781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; 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.