| Capital Regional Healthcare Llc | |
|
2770 Capital Medical Blvd Ste 200 Tallahassee FL 32308-8419 | |
| (850) 877-0910 | |
| Not Available |
| Full Name | Capital Regional Healthcare Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2770 Capital Medical Blvd Ste 200, Tallahassee, Florida |
| Authorized Official Name and Position | William Tedrick Johnson (VICE PRESIDENT) |
| Authorized Official Contact | 6153723375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Capital Regional Healthcare Llc 2000 Health Park Dr Brentwood TN 37027-4692 Ph: (615) 372-5426 | Capital Regional Healthcare Llc 2770 Capital Medical Blvd Ste 200 Tallahassee FL 32308-8419 Ph: (850) 877-0910 |
| NPI Number | 1417127499 |
|---|---|
| Provider Enumeration Date | 03/06/2008 |
| Last Update Date | 03/23/2021 |
| Medicare PECOS PAC ID | 4486724846 |
|---|---|
| Medicare Enrollment ID | O20080528000616 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417127499 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RC0200X | Internal Medicine - Critical Care Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeffery S Snyder |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1447234364 PECOS PAC ID: 8527047349 Enrollment ID: I20040719000094 |
| Provider Name | Adrienne P George |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679505630 PECOS PAC ID: 6103873922 Enrollment ID: I20050405000070 |
| Provider Name | Leonard J Waldenberger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477556728 PECOS PAC ID: 0749383966 Enrollment ID: I20070308000406 |
| Provider Name | Brenda Broger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881894574 PECOS PAC ID: 6507958790 Enrollment ID: I20070817000076 |
| Provider Name | Shawn R Ramsey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265650766 PECOS PAC ID: 1759461577 Enrollment ID: I20080107000556 |
| Provider Name | Michael L Douso |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053350199 PECOS PAC ID: 3072641786 Enrollment ID: I20100517000256 |
| Provider Name | Sara Elizabeth Randall-macdonnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225293764 PECOS PAC ID: 4789858705 Enrollment ID: I20111130000760 |
| Provider Name | Roberto Morales |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417989500 PECOS PAC ID: 1153588587 Enrollment ID: I20120213000585 |
| Provider Name | Anthony J Wright |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265523518 PECOS PAC ID: 7719115138 Enrollment ID: I20140110000660 |
| Provider Name | Jasmine A Shah |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1992912141 PECOS PAC ID: 8426101049 Enrollment ID: I20140416000804 |
| Provider Name | Rohan A Joseph |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659649432 PECOS PAC ID: 0446487615 Enrollment ID: I20141031001456 |
| Provider Name | Brittany K Clark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821383431 PECOS PAC ID: 7113149030 Enrollment ID: I20141110000962 |
| Provider Name | Sotiris C Stamou |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1316078835 PECOS PAC ID: 8527126408 Enrollment ID: I20141125000719 |
| Provider Name | Paul Modafferi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760880082 PECOS PAC ID: 6507183910 Enrollment ID: I20150324001703 |
| Provider Name | Brian L Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275598278 PECOS PAC ID: 1456371129 Enrollment ID: I20151015001167 |
| Provider Name | Jeffrey S Kirk |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1740449891 PECOS PAC ID: 6305098351 Enrollment ID: I20151207002822 |
| Provider Name | Shamil C Castro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568808574 PECOS PAC ID: 7113140005 Enrollment ID: I20161011000104 |
| Provider Name | Maci J Mcdermott |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093158818 PECOS PAC ID: 3173766300 Enrollment ID: I20161112000339 |
| Provider Name | Ying M Kung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487661278 PECOS PAC ID: 2365721404 Enrollment ID: I20161114001777 |
| Provider Name | Miles Eugene Byrd |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366605073 PECOS PAC ID: 7618250630 Enrollment ID: I20170606001794 |
| Provider Name | Kevin N Holder |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1841418894 PECOS PAC ID: 5597862300 Enrollment ID: I20180220001405 |
| Provider Name | Kinsey Callaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881192441 PECOS PAC ID: 8224391941 Enrollment ID: I20180411001259 |
| Provider Name | Heather Dawn Upchurch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326556036 PECOS PAC ID: 6103181961 Enrollment ID: I20180525001307 |
| Provider Name | Deborah R Melendez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720588866 PECOS PAC ID: 5294080214 Enrollment ID: I20180615000649 |
| 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 | Hiyam Abdelmagid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174979157 PECOS PAC ID: 4587996335 Enrollment ID: I20191028001124 |
| Provider Name | Pamala Ann Clayton |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1205433091 PECOS PAC ID: 0345650628 Enrollment ID: I20201028001660 |
| Provider Name | Candace Elise Gonzalez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811351364 PECOS PAC ID: 3678974227 Enrollment ID: I20210702000742 |
| Provider Name | Susan Liipfert Shelton |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1790426963 PECOS PAC ID: 4385021302 Enrollment ID: I20220512002874 |
| Provider Name | Tonya Renee Hawkes |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1184355901 PECOS PAC ID: 9234512674 Enrollment ID: I20220817001210 |
| Provider Name | William Kolby Ball |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740779065 PECOS PAC ID: 8921477449 Enrollment ID: I20221205003342 |
| Provider Name | Stevey Elyse Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962121095 PECOS PAC ID: 2365813292 Enrollment ID: I20230131003362 |
| Provider Name | Arian Kay Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255999371 PECOS PAC ID: 0244603918 Enrollment ID: I20230228000120 |
| Provider Name | Dana Marie Ivester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396452363 PECOS PAC ID: 6305203522 Enrollment ID: I20230602002150 |
| Provider Name | Christie Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447958814 PECOS PAC ID: 6406216613 Enrollment ID: I20230720000045 |
| Provider Name | Taylor L Larson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619505401 PECOS PAC ID: 4284056987 Enrollment ID: I20230912000349 |
| Provider Name | Prathyusha Pamidi Larson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700414596 PECOS PAC ID: 2466875679 Enrollment ID: I20230914003942 |
| Provider Name | Cheyne Andrew Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053099168 PECOS PAC ID: 0042668113 Enrollment ID: I20231129003961 |
Healing Hearts Music Therapy, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1862 Newman Ln, Tallahassee, FL 32312 Phone: 229-400-0722 | |
Titan Hospitalist Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2626 Capital Medical Blvd, Tallahassee, FL 32308 Phone: 904-332-4316 Fax: 904-332-4339 | |
Big Bend Hospice, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1723 Mahan Center Blvd, Tallahassee, FL 32308 Phone: 702-960-2272 | |
Guidewell Sanitas I, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1415 Timberlane Rd, Tallahassee, FL 32312 Phone: 844-665-4827 | |
Guidewell Sanitas I, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1415 Timberlane Rd, Tallahassee, FL 32312 Phone: 844-665-4827 | |
Tallahassee Memorial Healthcare Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3900 Esplanade Way, Tallahassee, FL 32311 Phone: 850-431-3867 Fax: 850-431-3879 | |
Transition Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3333 Capital Oaks Dr, Tallahassee, FL 32308 Phone: 850-431-4470 Fax: 850-431-4471 |