| Internal Medicine & Pediatrics Wellness Center | |
|
6038 W. Nordling Loop Crystal River FL 34429 | |
| (352) 795-2459 | |
| (352) 795-4322 |
| Full Name | Internal Medicine & Pediatrics Wellness Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 6038 W. Nordling Loop, Crystal River, Florida |
| Authorized Official Name and Position | Carlene A. Wilson (OWNER/PHYSICIAN) |
| Authorized Official Contact | 3527952459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine & Pediatrics Wellness Center Po Box 2012 Lecanto FL 34460 Ph: (352) 795-2459 | Internal Medicine & Pediatrics Wellness Center 6038 W. Nordling Loop Crystal River FL 34429 Ph: (352) 795-2459 |
| NPI Number | 1992825145 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 06/05/2014 |
| Medicare PECOS PAC ID | 9739103920 |
|---|---|
| Medicare Enrollment ID | O20060113000721 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992825145 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | ME93743 (Florida) | Primary |
| 208000000X | Pediatrics | ME93743 (Florida) | Secondary |
| Provider Name | Carlene Angella Phoenix Wilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407850365 PECOS PAC ID: 1658330006 Enrollment ID: I20060117000828 |
| Provider Name | Carolina Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558590752 PECOS PAC ID: 0446412456 Enrollment ID: I20121106000555 |
| Provider Name | Jennifer Sue Hegarty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588800726 PECOS PAC ID: 2567655756 Enrollment ID: I20141210000393 |
| Provider Name | Mary E Macdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114205200 PECOS PAC ID: 0840460481 Enrollment ID: I20160922001140 |
| Provider Name | Charles F. Brinegar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174033435 PECOS PAC ID: 7517229248 Enrollment ID: I20180316002057 |
| Provider Name | Valorea Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649371527 PECOS PAC ID: 0143561548 Enrollment ID: I20190412000287 |
| Provider Name | Melissa J Medlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528534161 PECOS PAC ID: 3678802279 Enrollment ID: I20190906002506 |
| Provider Name | Traci Marie Miramontes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609493279 PECOS PAC ID: 5597171132 Enrollment ID: I20210308000213 |
| Provider Name | Shauna Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831797513 PECOS PAC ID: 2163833708 Enrollment ID: I20210826000138 |
| Provider Name | Angela M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881288256 PECOS PAC ID: 7416346523 Enrollment ID: I20211111000687 |
| Provider Name | Jennifer Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982192324 PECOS PAC ID: 3072878271 Enrollment ID: I20231002000453 |
| Provider Name | Pam Rawat-katoch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649046624 PECOS PAC ID: 7315390341 Enrollment ID: I20240125004651 |
Rolf Lyon Urgent Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 155 Se Highway 19, Crystal River, FL 34429 Phone: 352-563-0184 Fax: 352-563-0195 | |
Advanced Gastroenterology Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6152 W Corporate Oaks Dr, Crystal River, FL 34429 Phone: 352-564-3900 Fax: 352-564-3903 | |
Nature Coast Provider Outreach Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7562 W Gulf To Lake Hwy, Crystal River, FL 34429 Phone: 352-436-4328 Fax: 352-260-0960 | |
Tampa General Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1601 Se Us Highway 19 Ste 1669, Crystal River, FL 34429 Phone: 352-563-2407 | |
Hospitalists Of Citrus County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6201 N Suncoast Blvd, Crystal River, FL 34428 Phone: 352-601-2375 Fax: 813-200-3667 | |
Triple Aim Medical Solutions, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7562 W Gulf To Lake Hwy, Crystal River, FL 34429 Phone: 352-436-4328 | |
My Pharmacy Crystal River, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 927 N Citrus Ave, Crystal River, FL 34428 Phone: 352-565-7342 Fax: 352-565-5880 |