Family Health Center of Columbia County, Inc.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

5080000065 Issued in FL

Legal business name

FAMILY HEALTH CENTER OF COLUMBIA COUNTY, INC.

Practice address

173 NW Albritton LN
Lake City, FL 32055-0249

Phone

(386) 758-5552

Fax

(386) 752-9143

NPI assigned

Apr 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John T Myles

Title

Ceo

Phone

(386) 758-5552

Specialties & licenses 6

Addresses

Other identifiers 10

Other names 1

• selected Doing business as

Practitioners 9

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

• Jean-Felert Cadet, M.D MPH

  • Family Medicine Physician
  • Lake City, FL
  • NPI 1548251226
  NPD (past)
• Larry J Latour, O.D. P.A.

  • Optometrist
  • Alachua, FL
  • NPI 1114191012
  NPD (past)
• Judy Ann Mayor-Davies, MD

  • Family Medicine Physician
  • Melbourne, FL
  • NPI 1043293830
  NPD (past)
• John P Odonnell, PA-C

  • Physician Assistant
  • Lake City, FL
  • NPI 1891795175
  NPD (past)
• Ambarish Gopal, M.D.

  • Cardiovascular Disease Physician
  • Plano, TX
  • NPI 1205008026
  NPD (past)
• Lavanya Gopalakrishnan

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1144259706
  NPD (past)
• Jan Gurney, D.O.

  • Family Medicine Physician
  • Somerville, NJ
  • NPI 1447244793
  NPD (past)
• Rohit Suri, MD

  • Obesity Medicine (Family Medicine) Physician
  • Fairfax, VA
  • NPI 1962488056
  NPD (past)
• Vida V Umstead, NP

  • Nurse Practitioner
  • Canton, GA
  • NPI 1366471914
  NPD (past)

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287100800000",
    "number": "1962464248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320560249",
            "telephone_number": "386-758-5552",
            "fax_number": "386-752-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 NW ALBRITTON LN",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320550249",
            "telephone_number": "386-758-5552",
            "fax_number": "386-752-9143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTER OF COLUMBIA COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-04",
        "last_updated": "2010-10-15",
        "status": "A",
        "authorized_official_last_name": "MYLES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "386-758-5552",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME92183",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "5080000065",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA0003548",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9101298",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "1181972",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2908802",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023552300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292277100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "ME92183",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "033364600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE",
            "identifier": "PA9101298",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORIGINAL LICENSE",
            "identifier": "5080000065",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE",
            "identifier": "PA0003548",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE",
            "identifier": "1181972",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "273713200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "290374100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "selected",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristyn Ann Faircloth, LCSW
• Mohammad A Faisal, M.D.
• Faith Works in Motion, Inc
• Michelle A Faller, NP-C
• Family & Love First Homecare LLC
• Fanney Spine and Rehab, P.a.
• David Grafton Fanney, DO
• Natalie E Farmer
• Marissa Farris
• Joyce Janice Feagle, LCSW

• Clinic/Center in Lake City, FL
• Providers in Lake City, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; 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.