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EMBRY-RIDDLE AERONAUTICAL UNIVERSITY, INC.
NPI 1679097307
General Practice in Daytona Beach, FL

Active since August 03, 2017CLIA 10D0681366 · Waiver
600 S CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114(386) 226-7912 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Aug 3, 2017 (2 updates tracked since 2017).

About Embry-riddle Aeronautical University, Inc. NPPES

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

EMBRY-RIDDLE AERONAUTICAL UNIVERSITY, INC. (NPI 1679097307) is a healthcare organization registered as a general practice in Daytona Beach, Florida and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Marianne Baskin, Director, as its authorized official.

NPPES Registry Identity

NPI1679097307
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameEMBRY-RIDDLE AERONAUTICAL UNIVERSITY, INC.
Location Address600 S CLYDE MORRIS BLVDDaytona Beach, FL 32114-3966
Mailing Address600 S Clyde Morris BlvdDaytona Beach, FL 32114-3966 · (386) 226-7912
Phone(386) 226-7912
Organization SubpartYes
Authorized OfficialMarianne BaskinDirector · (386) 226-7912
Enumeration DateAugust 3, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1679097307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
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
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
600 S CLYDE MORRIS BLVD, Daytona Beach, FL 32114
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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

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 10D0681366

Embry-Riddle Aeronautical University Health Services · Daytona Beach, FL
Active · expires Aug 31, 2026
CLIA Number10D0681366
Laboratory TypeSchool/Student Health Service
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorRyan Rees
Laboratory Phone(386) 226-7917
Laboratory LocationEmbry-Riddle Aeronautical University Health Services1 Aerospace Blvd.Bldg 500, Daytona Beach, FL 32114
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

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

ANDA UDRIS
Specialist/Technologist (Athletic Trainer)
600 S CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114
Volusia County (386) 226-6417
HAYLEY MICHELE EDENZON ATC
Specialist/Technologist (Athletic Trainer)
600 S CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114
Volusia County (386) 323-8700
STEVEN SAMPLES MS, ATC, LAT, PES
Specialist/Technologist (Athletic Trainer)
600 S CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114
Volusia County (386) 226-7546
KELLEY ELIZABETH HARRISON M.HRD, ATC/LAT
Specialist/Technologist (Athletic Trainer)
600 S CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114
Volusia County (386) 226-7785
MARIA C PUENTES ARNP
Nurse Practitioner (Primary Care)
600 S CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114
Volusia County (386) 226-7917
MR. JUSTIN PATRICK WHITE ATC, CSCS, NSCA-CPT
Specialist/Technologist (Athletic Trainer)
600 S CLYDE MORRIS BLVD
DAYTONA BEACH, FL 32114
Volusia County (386) 226-6527

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 Embry-Riddle Aeronautical University, Inc.'s NPI number?

The NPI number for Embry-Riddle Aeronautical University, Inc. is 1679097307. It was assigned to this organization in the NPPES registry on August 3, 2017.

Where is Embry-Riddle Aeronautical University, Inc. located?

Embry-Riddle Aeronautical University, Inc. is located at 600 S Clyde Morris Blvd, Daytona Beach, FL 32114. The listed phone number is (386) 226-7912.

What is Embry-Riddle Aeronautical University, Inc.'s specialty?

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

Does Embry-Riddle Aeronautical University, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0681366) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Embry-Riddle Aeronautical University, Inc. was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.