Alliance Physician Group LLC

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Legal business name

ALLIANCE PHYSICIAN GROUP LLC

Practice address

855 Saint Johns Bluff Rd N
Sky Harbor, Unit 703
Jacksonville, FL 32225-7309

Phone

(800) 991-6508

NPI assigned

Aug 27, 2014

Last updated

Aug 27, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrew Eriksen

Title

Director

Phone

(904) 746-4664

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409097600000",
    "number": "1104226158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 SAINT JOHNS BLUFF RD N",
            "address_2": "SKY HARBOR, UNIT 703",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322257309",
            "telephone_number": "800-991-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 SAINT JOHNS BLUFF RD N",
            "address_2": "SKY HARBOR, UNIT 703",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322257309",
            "telephone_number": "800-991-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIANCE PHYSICIAN GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-08-27",
        "status": "A",
        "authorized_official_last_name": "ERIKSEN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-746-4664"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Exclusive Provider Organization in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Exclusive Provider Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.