ARCHBOLD MEDICAL GROUP NPI 1124051040

NPI Information

  • NPI: 1124051040
  • Provider Name: ARCHBOLD MEDICAL GROUP
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: GERRY MEDICAL CENTER
  • CLIA Number: 11D2214605
  • Address: 555 N JEFFERSON ST
    MONTICELLO, FL
    ZIP 32344
  • Phone: (850) 997-2511

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NPI Details

ARCHBOLD MEDICAL GROUP is a family medicine in Monticello, FL. The provider is 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. ARCHBOLD MEDICAL GROUP NPI is 1124051040. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Gerry Medical Center.

The provider's business location address is:

555 N JEFFERSON ST
MONTICELLO, FL
ZIP 32344-060
Phone: (850) 997-2511
Fax: (850) 997-3022

The provider's authorized official is Charles D Hightower .
The authorized official title is Chief Financial Officer and has the following contact phone number (229) 228-2853.

The CLIA number assigned to this NPI record is 11D2214605 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2006 and was last updated on 10/7/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineME0085940FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1K1215MEDICARE ID-TYPE UNSPECIFIEDFLORIDA
2267978700MEDICAIDFLORIDA
310D0270322OTHERCLIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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