Halifax Health Express Care – Urgent Care Clinic/Center, NPI 1093308504

Halifax Health Express Care is a healthcare provider. based in Port orange, Florida. specializing in Urgent Care Clinic/Center. The NPI Number for Halifax Health Express Care is 1093308504

Main info

Organization
Name
Halifax Health Express Care
NPI
1093308504
Phone
(423) 531-1330
Address
5440 S Williamson Blvd
Authorized Official
KATHERINE ELIZABETH PENDERGRASS DIRECTOR OF REVENUE CYCLE
Enumeration Date
16 February 2021
Last Update Date
10 April 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness80
Years active:5State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Halifax Health Express Care

  • 5440 S Williamson Blvd

    Port Orange, FL 32128

    Phone: (423) 531-1330

    Fax: (386) 845-5455

    Type: Location

  • 1688 W Granada Blvd Ste 1C

    Ormond Beach, FL 321741818

    Phone: (423) 531-1330

    Fax: (386) 845-5457

    Type: Location

  • 2090 Saxon Blvd

    Deltona, FL 327253251

    Phone: (423) 531-1330

    Type: Location

  • 3048 S ATLANTIC AVE

    DAYTONA BEACH, FL 321186102

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-08-31

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20210831002196OClinic/Group PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32128)

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Reviews

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Frequently asked questions

What is the registry number for Halifax Health Express Care?
The registry entry for Halifax Health Express Care shows NPI 1093308504.
Should I treat Halifax Health Express Care as an active provider?
Patients and plans typically see Halifax Health Express Care as active in the national extract.
Which specialty label fits Halifax Health Express Care?
NPPES ties Halifax Health Express Care to Urgent Care Clinic/Center in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to Halifax Health Express Care?
Halifax Health Express Care shows a connection to Port Orange, Florida in registry-derived data.
Can I export Halifax Health Express Care's record?
You can download the official NPPES record; we summarize key fields for readability.

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