NPIMap

Organization Active NPI

Medfast Urgent Care Center, LLC

  • Urgent Care Clinic/Center
  • Cocoa Beach, FL
National Provider Identifier
1972809275
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
OS6588 Issued in FL
Legal business name
MEDFAST URGENT CARE CENTER, LLC
Practice address
275 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3529
Phone
(321) 751-7222
Fax
(321) 751-6655
NPI assigned
Feb 3, 2011
Organization subpart
Yes
Parent organization
MEDFAST URGENT CARE CENTER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Authorized official

Name
David Thomas Williams, D.O.NPI 1760484034
Title
Managing Member
Phone
(321) 799-7777

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
Urgent Care Clinic/Center 261QU0200X OS6588 FL Primary

Addresses

Primary practice location

275 W Cocoa Beach Cswy
Cocoa Beach, FL 32931-3529

Mailing address

PO Box 160961
Altamonte Springs, FL 32716-0961
Phone (321) 751-7222

Other identifiers 1

IdentifierTypeStateIssuer
OS6588OtherFLMEDICAL LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Medfast Urgent Care Centers LLC20 organizations share this tax ID, including this one
Part of
Medfast Urgent Care Centers LLC

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1296691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626220800000",
    "number": "1972809275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160961",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327160961",
            "telephone_number": "321-751-7222",
            "fax_number": "321-751-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W COCOA BEACH CSWY",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329313529",
            "telephone_number": "321-751-7222",
            "fax_number": "321-751-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFAST URGENT CARE CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDFAST URGENT CARE CENTER, LLC",
        "enumeration_date": "2011-02-03",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "321-799-7777",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": "OS6588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "OS6588",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.