| Meadowcrest Physicians Partners Llc | |
|
6199 W Gulf To Lake Hwy Crystal River FL 34429-2679 | |
| (352) 795-0644 | |
| (352) 795-5950 |
| Full Name | Meadowcrest Physicians Partners Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 6199 W Gulf To Lake Hwy, Crystal River, Florida |
| Authorized Official Name and Position | Alex J Dickert (OWNER) |
| Authorized Official Contact | 3527950644 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meadowcrest Physicians Partners Llc 6199 W Gulf To Lake Hwy Crystal River FL 34429-2679 Ph: (352) 795-0644 | Meadowcrest Physicians Partners Llc 6199 W Gulf To Lake Hwy Crystal River FL 34429-2679 Ph: (352) 795-0644 |
| NPI Number | 1346608742 |
|---|---|
| Provider Enumeration Date | 02/01/2016 |
| Last Update Date | 02/01/2016 |
| Medicare PECOS PAC ID | 7214233485 |
|---|---|
| Medicare Enrollment ID | O20160315000284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346608742 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jimmy C Dickert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073695755 PECOS PAC ID: 3577582170 Enrollment ID: I20051115000118 |
| Provider Name | Franz J Plum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073710364 PECOS PAC ID: 2466517784 Enrollment ID: I20090219000362 |
| Provider Name | Alex Jonathan Dickert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427342245 PECOS PAC ID: 6305094525 Enrollment ID: I20120913000238 |
| Provider Name | Mary Ann Ferguson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194159301 PECOS PAC ID: 3779717830 Enrollment ID: I20131004000161 |
| Provider Name | Ryan Spencer Dickert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306231212 PECOS PAC ID: 8628382983 Enrollment ID: I20161026001624 |
| Provider Name | Jeri L Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356864599 PECOS PAC ID: 2567736853 Enrollment ID: I20170926001285 |
| Provider Name | Coty J Tino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073909982 PECOS PAC ID: 4587978119 Enrollment ID: I20180918002300 |
| Provider Name | Meghan Trenary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366907065 PECOS PAC ID: 3375978133 Enrollment ID: I20200124000956 |
| Provider Name | Kayla M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275213365 PECOS PAC ID: 3870957053 Enrollment ID: I20230907001455 |
| Provider Name | Shaila M Shenai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699945980 PECOS PAC ID: 5294800330 Enrollment ID: I20231003004056 |
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