GENESIS FAMILY PRACTICE, LLC – NPI #1023369204
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

GENESIS FAMILY PRACTICE, LLC is a provider located in ORANGE CITY, FL. NPPES has assigned the NPI number 1023369204 to GENESIS FAMILY PRACTICE, LLC on September 27, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 4 years ago on Nov 28, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for GENESIS FAMILY PRACTICE, LLC below.

NPI Profile for
GENESIS FAMILY PRACTICE, LLC

NPI Number
1023369204
Enumeration Date

(more than 13 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GENESIS FAMILY PRACTICE, LLC
Primary location
1133 SAXON BLVD
ORANGE CITY, FL 32763-8425
Phone: (386) 228-9700 Fax:
1 Other location(s):
800 S Nova Rd Ste I
Ormond Beach, FL 32174-7362
Phone: (386) 228-9700
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JAY CHANMUGAM
OWNER
Phone: (386) 878-4137
Updated
Certification Date
Nov 28, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for GENESIS FAMILY PRACTICE, LLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidFL008488100
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
FL OS8600
291U00000X
- Clinical Medical Laboratory

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.