ORMOND INTERNAL MEDICINE LLC
NPI 1023209095
Internal Medicine in Ormond Bch, FL

Active since August 06, 2007CLIA 10D0967903 · Waiver
279 S. YONGE ST., ORMOND BCH, FL 32174(386) 673-2133(386) 673-2743 Get Directions Write a Review

NPPES record last updated: July 25, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ormond Internal Medicine Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ORMOND INTERNAL MEDICINE LLC (NPI 1023209095) is a healthcare organization registered as an internal medicine in Ormond Bch, Florida and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through August 9, 2026 and lists Patricia Gail Vandiepen, Owner, as its authorized official.

NPPES Registry Identity

NPI1023209095
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameORMOND INTERNAL MEDICINE LLC
Location Address279 S. YONGE ST.Ormond Bch, FL 32174
Mailing Address279 S. Yonge St.Ormond Bch, FL 32174 · (386) 673-2133 · Fax (386) 673-2743
Fax(386) 673-2743
Organization SubpartNo
Authorized OfficialPatricia Gail VandiepenOwner · (386) 673-2133
Enumeration DateAugust 6, 2007
Last NPPES UpdateJuly 25, 2024
NPPES CertifiedJuly 25, 2024
NPI 1023209095 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in FL · OS7544
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

279 S. YONGE ST., Ormond Bch, FL 32174

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0967903

Ormond Internal Medicine LLC · Ormond Beach, FL
Active · expires Aug 9, 2026
CLIA Number10D0967903
Laboratory TypePhysician Office
Certificate Effective DateAugust 10, 2024
Certificate Expiration DateAugust 9, 2026
Laboratory DirectorGail Van Diepen
Laboratory Phone(386) 673-2133
Laboratory LocationOrmond Internal Medicine LLC279 S Yonge St, Ormond Beach, FL 32174
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1023209095, enumerated as an "organization" on August 06, 2007.

The provider is located at 279 S. YONGE ST. ORMOND BCH, FL 32174 and the phone number is (386) 673-2133.

Internal Medicine with taxonomy code 207R00000X.