Trenton Medical Center, Inc
Organization Active NPI Federally Qualified Health Center (FQHC) · Lake City, FL
NPI 1972140358 · NPPES record last updated Jan 10, 2025
Key facts
- NPI
- 1972140358
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- TRENTON MEDICAL CENTER, INC
- Practice address
- 4784 W US Highway 90
Lake City, FL 32055-3101 - Phone
- (386) 269-9260
- Fax
- (386) 406-6714
- NPI assigned
- Dec 5, 2019
- Organization subpart
- No
Authorized official
- Name
- Anita H. Rembert
- Title
- Ceo
- Phone
- (386) 454-0698
Owners & managing parties with NPI records 12
Owned or controlled facilities with NPI records 8
Other NPIs on the same Medicare enrollment 13
Other NPIs with the same Medicare PAC ID 12
Corporate family (same tax ID) 14
Facilities with the same owner 8
Practitioners 74
-
James Dawson, PA-C
-
Heather Hobbs Lee, PA-C
-
Lydia Moreno, APRN
-
Stephen Reeder, PA-C
-
Lilia Del Mundo Acebron, ARNP
-
Jody Lynne Arnstein, APRN
-
Alexandra Baker, PA-C
-
Sharon Baldauf-Madero, PA-C
-
Matthew Barber, APRN
-
Payal Bhatt Abraham, M.D.
-
Chad Billington II, LMHC
-
Sheryl Burke, APRN
-
Risa Weletcka Clayton, APRN
-
Crystal Breeze Cullen, APRN
-
Grace Dunn, M.D.
-
Haley Ford, PA-C
-
John D Frazier, D.C.
-
Sydney Graybill, PA-C
-
Sydney Griffith, PA-C
-
Beth Harris Henderson, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in FL
Federally qualified health center certification: CCN 681168
- Legal name
- TRENTON MEDICAL CENTER INC
- Doing business as
- PALMS MEDICAL GROUP
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 6, 2020
- Last certification
- Jan 6, 2020
- Ownership / control type
- For profit – partnership
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 4784 W US Highway 90
Lake City, FL 32055-3101
All disclosed owners & managing parties 13
| Name | Role | Since | Share |
|---|---|---|---|
| Stephen Elder |
Corporate Director |
Jan 1, 2018 | |
| Sarah Catalanotta |
Corporate Director |
Jan 1, 2014 | |
| Andrew Jones |
Corporate Director |
Oct 16, 2023 | |
| Gail M Osteen |
Corporate Director |
Jan 1, 1988 | |
| Anita Rembert |
Corporate Director |
Apr 23, 2001 | 100% |
| W-2 Managing Employee |
Apr 23, 2001 | 100% | |
| Trenton Medical Center Inc |
5% Or Greater Direct Ownership Interest | Jan 10, 2020 | 100% |
| Charles E Hatch |
Corporate Director |
Jan 1, 2007 | |
| Clifton E Bradley |
Corporate Director |
Jan 1, 1988 | |
| Julie Calvitt |
Corporate Director | Jan 1, 2025 | |
| Melissa Snodgrass |
Corporate Director | May 4, 2022 | |
| Marilyn T Thompson |
Corporate Director |
Jan 1, 2005 | |
| Linda D Walker |
Corporate Director |
Jan 1, 1999 | |
| Juan B Henley |
Corporate Director |
Jan 1, 1994 |
All facility ownership & control disclosures 8
| Facility | Type | Role | Since |
|---|---|---|---|
| Palms Medical Group |
Federally qualified health center | Operational/Managerial Control (100%) | Feb 27, 2014 |
| Palms Medical Group |
Federally qualified health center | Operational/Managerial Control (100%) | Feb 27, 2014 |
| Palms Medical Group |
Federally qualified health center | Operational/Managerial Control (100%) | Feb 27, 2014 |
| Palms Medical Group |
Federally qualified health center | Operational/Managerial Control | Feb 27, 2014 |
| Palms Medical Group |
Federally qualified health center | Operational/Managerial Control (100%) | Jul 1, 2014 |
| Palms Medical Group, Family Healthcare Center of Columbia County |
Federally qualified health center | Operational/Managerial Control (100%) | Feb 27, 2014 |
| Palms Medical Group |
Federally qualified health center | Operational/Managerial Control (100%) | Oct 10, 2022 |
| Palms Medical Group |
Federally qualified health center | Operational/Managerial Control | Jul 24, 2023 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050428000865 | FL | Part B Supplier - Clinic/Group Practice | 2365359387 |
Receives reassigned benefits from 129 practitioners 13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lake City, FL; Williston, FL; Trenton, FL; Starke, FL; Orange Park, FL; Live Oak, FL; High Springs, FL; Gainesville, FL… |
| O20200106000032 | FL | Part a Provider - Federally Qualified Health Center (FQHC) | 2365359387 | Practice locations: Lake City, FL |
National Provider Directory
- Tax ID family
- Trenton Medical Center Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
4784 W US Highway 90
Lake City, FL 32055-3101
Mailing address
23476 NW 186TH Ave
High Springs, FL 32643-0673
Phone (386) 454-0698
Other names
- Palms Medical Group
Other providers in Lake City, FL
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- Tranquility Therapy Services, LLC
- Tranquility Therapy Services, LLC
- Justin M Trapani
- Casey Trent
- Trenton Medical Center, Inc.
- Trenton Medical Center, Inc.
- Trenton Medical Center, Inc.
- Triangle Urology Care
- Jennifer Troiano
All providers in Lake City, FL · Federally Qualified Health Center (FQHC) in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.