New Horizons: Women's Medical Group, P.a.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

NEW HORIZONS: WOMEN'S MEDICAL GROUP, P.A.

Practice address

802 Port Wine LN
Jacksonville, FL 32225-5230

Phone

(904) 220-3725

NPI assigned

Aug 26, 2005

Last updated

Aug 22, 2020By 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

Ms. Debbie Willis

Title

Business Administrator

Phone

(904) 281-0780

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114910924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 UNIVERSITY BLVD S",
            "address_2": "SUITE 215",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164377",
            "telephone_number": "904-296-3200",
            "fax_number": "904-296-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 PORT WINE LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322255230",
            "telephone_number": "904-220-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HORIZONS: WOMEN'S MEDICAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "BUSINESS ADMINISTRATOR",
        "authorized_official_telephone_number": "904-281-0780",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "45591",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• New Life Surgical Associates PLLC

• Obstetrics & Gynecology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.