FLORIDA PRIMARY CARE AND SPORTS MEDICINE, INC.
NPI 1548819741
Family Medicine in Palm Coast, FL

NPI Status: Active since September 10, 2019

Contact Information

140 PINNACLES DR
PALM COAST, FL
ZIP 32164
Phone: (386) 597-2829
Fax: (386) 313-1923

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  • Organization
  • Family Medicine
  • CLIA Number: 10D2173533
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 10-14-2027

About FLORIDA PRIMARY CARE AND SPORTS MEDICINE, INC.

This page provides the complete NPI Profile along with additional information for Florida Primary Care And Sports Medicine, Inc., a primary care provider established in Palm Coast, Florida operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1548819741 assigned on September 2019. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Ann Shaw (Administrator)

NPI
1548819741
Provider Name
FLORIDA PRIMARY CARE AND SPORTS MEDICINE, INC.
Entity Type
Organization
Location Address
140 PINNACLES DR PALM COAST, FL 32164
Location Phone
(386) 597-2829
Location Fax
(386) 313-1923
Mailing Address
6 OFFICE PARK DR PALM COAST, FL 32137
Mailing Phone
(386) 447-6615
Mailing Fax
(386) 313-1923
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-10-2019
Last Update Date
07-01-2025
Code Navigator

A primary care provider (PCP) like Florida Primary Care And Sports Medicine, Inc. sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1261QP2300XAmbulatory Health Care Facilities

Clinic/Center
Primary Care

 

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ANN SHAW

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(386) 447-6615

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
10D2173533
Facility Type
Physician Office
Certificate Effective Date
October 15, 2025
Certificate Expiration Date
October 14, 2027
Laboratory Director
BRIAN T. BOGDANOWICZ
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Florida Primary Care And Sports Medicine, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1548819741, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 79. The final step is to find the difference between that total and the next multiple of ten (80 - 79 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
4
Doubled → 8
Pos 4
8
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
1
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
7
Unchanged
Pos 9
4
Doubled → 8
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 8 → 16 → 7 9 → 18 → 9 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 8 + 8 + 1 + 6 + 1 + 1 + 8 + 7 + 8 + 24 = 79

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 79 is 80. The difference is the calculated check digit.

80 - 79 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1548819741.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Clinic/Center
140 PINNACLES DR
PALM COAST, FL 32164
Nurse Practitioner (Family)
140 PINNACLES DR
PALM COAST, FL 32164
Nurse Practitioner (Family)
140 PINNACLES DR
PALM COAST, FL 32164

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1548819741, enumerated as an "organization" on September 10, 2019.

The provider is located at 140 PINNACLES DR PALM COAST, FL 32164 and the phone number is (386) 597-2829.

Family Medicine with taxonomy code 207Q00000X.