| Neighborhood Medical Center, Inc | |
|
438 W Brevard St Tallahassee FL 32301-1004 | |
| (850) 224-2469 | |
| (850) 513-3277 |
| Full Name | Neighborhood Medical Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 438 W Brevard St, Tallahassee, Florida |
| Authorized Official Name and Position | Jeanne S Freeman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8504592328 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neighborhood Medical Center, Inc 438 W Brevard St Tallahassee FL 32301-1004 Ph: (850) 224-2469 | Neighborhood Medical Center, Inc 438 W Brevard St Tallahassee FL 32301-1004 Ph: (850) 224-2469 |
| NPI Number | 1487869467 |
|---|---|
| Provider Enumeration Date | 05/11/2007 |
| Last Update Date | 03/28/2023 |
| Medicare PECOS PAC ID | 7517082837 |
|---|---|
| Medicare Enrollment ID | O20100909001205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487869467 | NPI | - | NPPES |
| 262263701 | Medicaid | FL | |
| 112813300 | Medicaid | FL | |
| 112813301 | Medicaid | FL | |
| 262263702 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Charlie E Richardson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1063401925 PECOS PAC ID: 1052393329 Enrollment ID: I20040602000521 |
| Provider Name | Sharron C Foster |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154365757 PECOS PAC ID: 4284695123 Enrollment ID: I20041023000013 |
| Provider Name | Daniel Delgado |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386832525 PECOS PAC ID: 0143305243 Enrollment ID: I20080313000499 |
| Provider Name | Lisa Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801884333 PECOS PAC ID: 1456430545 Enrollment ID: I20080430000502 |
| Provider Name | Denise Michel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700076627 PECOS PAC ID: 6305985516 Enrollment ID: I20100623000210 |
| Provider Name | Jose E Rodriguez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1447466081 PECOS PAC ID: 4385769389 Enrollment ID: I20100914001172 |
| Provider Name | Donald A Michel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861533572 PECOS PAC ID: 0345492732 Enrollment ID: I20131101001071 |
| Provider Name | Susan Y Dunbar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154689347 PECOS PAC ID: 1658508783 Enrollment ID: I20131218000268 |
| Provider Name | Rose Adaku Jonah Origa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083998579 PECOS PAC ID: 1456588581 Enrollment ID: I20131218000327 |
| Provider Name | Esaias Frank Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386655124 PECOS PAC ID: 6204919731 Enrollment ID: I20131230000309 |
| Provider Name | Alanna Steaple |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770690125 PECOS PAC ID: 2466680897 Enrollment ID: I20140110000959 |
| Provider Name | Marlaine F Registe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669768578 PECOS PAC ID: 2466681820 Enrollment ID: I20140205000155 |
| Provider Name | Hantz C Hercule |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1336232784 PECOS PAC ID: 7214033133 Enrollment ID: I20140213000598 |
| Provider Name | Tamesia A Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760556112 PECOS PAC ID: 8921225590 Enrollment ID: I20140806000993 |
| Provider Name | Kanesha S Cole |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1174773311 PECOS PAC ID: 0042437220 Enrollment ID: I20140812001354 |
| Provider Name | Lisa M Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245587666 PECOS PAC ID: 2769600733 Enrollment ID: I20140904001736 |
| Provider Name | Jennifer A Schnippert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801204987 PECOS PAC ID: 3678791589 Enrollment ID: I20140905000757 |
| Provider Name | Anthony D Mcguire |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1417226309 PECOS PAC ID: 6103048939 Enrollment ID: I20141112000681 |
| Provider Name | Shirley Croissy English |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265832802 PECOS PAC ID: 9234443060 Enrollment ID: I20150807015545 |
| Provider Name | Abisoye Somorin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689026924 PECOS PAC ID: 5193012631 Enrollment ID: I20160927000858 |
| Provider Name | Kyara Shanyce Paulk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053760512 PECOS PAC ID: 3971869041 Enrollment ID: I20171205002189 |
| Provider Name | Marcia Roberts-morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669886743 PECOS PAC ID: 5395003883 Enrollment ID: I20171209000185 |
| Provider Name | Brandi K Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497232797 PECOS PAC ID: 6406109933 Enrollment ID: I20181030001106 |
| Provider Name | Kenara Janay Blocker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578038675 PECOS PAC ID: 5698019651 Enrollment ID: I20181130002445 |
| Provider Name | Kendra Melanese Brady |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104315159 PECOS PAC ID: 6507100963 Enrollment ID: I20181212000984 |
| Provider Name | Katrina Ball |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1184188682 PECOS PAC ID: 8224377650 Enrollment ID: I20190301002506 |
| Provider Name | Jessica Shajuan Lea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962010819 PECOS PAC ID: 6002220787 Enrollment ID: I20210212000189 |
| Provider Name | Gabrielle Gardner Norris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619529344 PECOS PAC ID: 2264761923 Enrollment ID: I20210409001193 |
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