Immediate Care Center Of Starke | |
345 W Madison St Starke FL 32091-3923 | |
(904) 964-5455 | |
(904) 964-2015 |
Full Name | Immediate Care Center Of Starke |
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Speciality | Clinic/Center |
Location | 345 W Madison St, Starke, Florida |
Authorized Official Name and Position | Ellen Janine Sikes (PRESIDENT) |
Authorized Official Contact | 9049645455 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Immediate Care Center Of Starke 345 W Madison St Starke FL 32091-3923 Ph: (904) 964-5455 | Immediate Care Center Of Starke 345 W Madison St Starke FL 32091-3923 Ph: (904) 964-5455 |
NPI Number | 1487727038 |
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Provider Enumeration Date | 11/15/2006 |
Last Update Date | 07/17/2023 |
Medicare PECOS PAC ID | 0143207704 |
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Medicare Enrollment ID | O20040701000581 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487727038 | NPI | - | NPPES |
263114800 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Charles J Franson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1285707828 PECOS PAC ID: 9234116484 Enrollment ID: I20110509000150 |
Provider Name | Gloria Lynn Niquette |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366874174 PECOS PAC ID: 9436376035 Enrollment ID: I20140805001726 |
Provider Name | Stephania L Dejno |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639636194 PECOS PAC ID: 4981031580 Enrollment ID: I20200220000916 |
Provider Name | Ana Maria R Fishbein |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164991758 PECOS PAC ID: 0941631097 Enrollment ID: I20200506000226 |
Provider Name | Janna T Caines |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912504309 PECOS PAC ID: 4082034673 Enrollment ID: I20201021000082 |
Provider Name | Justin W Harrington |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699399279 PECOS PAC ID: 2365852969 Enrollment ID: I20201111000680 |
Provider Name | Cary L Howard |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1871172221 PECOS PAC ID: 9830507730 Enrollment ID: I20210414000079 |
Provider Name | Sandra Kamhoot |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831864883 PECOS PAC ID: 3072905926 Enrollment ID: I20220126002087 |
Provider Name | Alicia Greendeer Dollison |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538749858 PECOS PAC ID: 1658765656 Enrollment ID: I20220308000195 |
Provider Name | Jessica Cummings-nigh |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1598475394 PECOS PAC ID: 3173992195 Enrollment ID: I20221214002956 |
Provider Name | Angelica B Cooksey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1942984687 PECOS PAC ID: 5395104954 Enrollment ID: I20230629004065 |
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