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GENESIS FAMILY PRACTICE LLC
NPI 1447799242
General Practice in Ormond Beach, FL

Active since February 14, 2017
800 S NOVA RD, SUITE I, ORMOND BEACH, FL 32174(386) 676-9300(386) 676-9050 Get Directions Write a Review

NPPES record last updated: November 28, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 28, 2022, Apr 17, 2018, Mar 16, 2017 and 1 more (4 updates tracked since 2017).

About Genesis Family Practice Llc NPPES

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

GENESIS FAMILY PRACTICE LLC (NPI 1447799242) is a healthcare organization registered as a general practice in Ormond Beach, Florida and active in the NPI registry since February 2017. The organization lists Jay C Chanmugam, Owner, as its authorized official.

NPPES Registry Identity

NPI1447799242
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameGENESIS FAMILY PRACTICE LLC
Location Address800 S NOVA RD, SUITE IOrmond Beach, FL 32174-9048
Mailing Address1133 Saxon Blvd, Ste 200Orange City, FL 32763-8425 · (386) 218-2353 · Fax (386) 228-9701
Phone(386) 676-9300
Fax(386) 676-9050
Organization SubpartNo
Authorized OfficialJay C ChanmugamOwner · (386) 218-2353
Enumeration DateFebruary 14, 2017
Last NPPES UpdateNovember 28, 20224 updates tracked since enumeration
NPPES CertifiedNovember 28, 2022
✔ NPI 1447799242 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in FL · OS8600
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
800 S NOVA RD, Ormond Beach, FL 32174
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL).Insurance ›

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 10D2137312

Genesis Family Practice LLC · Ormond Beach, FL
Expired · Jul 13, 2026
CLIA Number10D2137312
Laboratory TypePhysician Office
Certificate Effective DateJuly 14, 2024
Certificate Expiration DateJuly 13, 2026
Laboratory DirectorJay Chanmugam
Laboratory Phone(386) 676-9300
Laboratory LocationGenesis Family Practice LLC800 S Nova Rd, Ormond Beach, FL 32174
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GENESIS GROUP OF FAMILY PRACTICES LLC
General Practice
800 S NOVA RD, STE J
ORMOND BEACH, FL 32174
Flagler County (386) 218-2353
JOHN B TURNER MD PA
Family Medicine
800 S NOVA RD, SUITE I
ORMOND BEACH, FL 32174
Flagler County (386) 676-9300
DANNIE EARL BUCK M.D.
Internal Medicine
800 S NOVA RD, SUITE A
ORMOND BEACH, FL 32174
Flagler County (386) 676-0505
MRS. ANN-MARIE VITALIS
Nurse Practitioner (Family)
800 S NOVA RD
ORMOND BEACH, FL 32174
Flagler County (386) 228-9700
YOUR DOCTOR'S OFFICE, INC.
Internal Medicine
800 S NOVA RD, SUITE A
ORMOND BEACH, FL 32174
Flagler County (386) 676-0505

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Genesis Family Practice LLC's NPI number?

The NPI number for Genesis Family Practice LLC is 1447799242. It was assigned to this organization in the NPPES registry on February 14, 2017.

Where is Genesis Family Practice LLC located?

Genesis Family Practice LLC is located at 800 S Nova Rd Suite I, Ormond Beach, FL 32174. The listed phone number is (386) 676-9300.

What is Genesis Family Practice LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

What insurance does Genesis Family Practice LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) list Genesis Family Practice LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Genesis Family Practice LLC was last updated on November 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.