Ebenezer Primary Medical Care Clinic LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

EBENEZER PRIMARY MEDICAL CARE CLINIC LLC

Practice address

166 Marion Oaks Blvd
Ocala, FL 34473-6216

Phone

(352) 203-5122

Fax

(352) 203-4355

NPI assigned

Oct 2, 2026

Last updated

Oct 2, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rolla Pierre

Title

Owner

Phone

(352) 203-5122

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1790899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790899200000",
    "number": "1972417145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2592 SW 156TH PL",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344733493",
            "telephone_number": "352-203-5122",
            "fax_number": "352-203-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 MARION OAKS BLVD",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344736216",
            "telephone_number": "352-203-5122",
            "fax_number": "352-203-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBENEZER PRIMARY MEDICAL CARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-02",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A",
        "authorized_official_last_name": "PIERRE",
        "authorized_official_first_name": "ROLLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-203-5122"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.