NPIMap

Organization Active NPI

Collier Hma Physician Management LLC

  • Internal Medicine Physician
  • Bonita Springs, FL
National Provider Identifier
1053056176
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COLLIER HMA PHYSICIAN MANAGEMENT LLC
Doing business as
Collier HMA Physician Management LLC
Practice address
8951 Bonita Beach Rd SE Ste 310
Bonita Springs, FL 34135-4222
Phone
(239) 348-4221
Fax
(239) 354-9509
NPI assigned
May 3, 2022
Last updated
May 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer L Jackson
Title
Sr Dir Prov Enrollment & CVS
Phone
(615) 465-3334

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

8951 Bonita Beach Rd SE Ste 310
Bonita Springs, FL 34135-4222

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (615) 465-7211

Other names 1

  • Collier HMA Physician Management LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Collier Hma Physician Management LLC37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

Organizations that report the same tax identification number in the National Provider Directory.

View all 36

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1053056176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "615-465-7211",
            "fax_number": "615-628-6877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8951 BONITA BEACH RD SE STE 310",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354222",
            "telephone_number": "239-348-4221",
            "fax_number": "239-354-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIER HMA PHYSICIAN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-03",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR DIR PROV ENROLLMENT & CVS",
        "authorized_official_telephone_number": "615-465-3334"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Collier HMA Physician Management LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.