NPIMap

Organization Active NPI

Sacred Heart Medical Group

  • Endocrinology, Diabetes & Metabolism Physician
  • Miramar Beach, FL
National Provider Identifier
1073285318
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
SACRED HEART MEDICAL GROUP
Practice address
7720 US Highway 98 W Ste 230&260
Miramar Beach, FL 32550-7230
Phone
(850) 278-3742
Fax
(850) 278-3753
NPI assigned
Oct 5, 2021
Last updated
Oct 5, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Authorized official

Name
Jean Vallier
Title
Director-Managed Care
Phone
(850) 278-3742

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU Primary
Rheumatology Physician 207RR0500X NU

Addresses

Primary practice location

7720 US Highway 98 W Ste 230&260
Miramar Beach, FL 32550-7230

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623

Other names 1

  • SHMG Destin Endo/Rheumatology Other name

National Provider Directory

National Provider Directory
Tax ID family
Sacred Heart Specialty99 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Locations

7720 US Highway 98 W
Ste 230260
Miramar Beach, FL 32550
Phone (850) 278-3742

NPI Registry JSON

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1073285318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7720 US HIGHWAY 98 W STE 230&260",
            "city": "MIRAMAR BEACH",
            "state": "FL",
            "postal_code": "325507230",
            "telephone_number": "850-278-3742",
            "fax_number": "850-278-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED HEART MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "VALLIER",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "DIRECTOR-MANAGED CARE",
        "authorized_official_telephone_number": "850-278-3742"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHMG Destin Endo/Rheumatology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Miramar Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.