Cogent Healthcare of Jacksonville, LLC

Organization Active NPI Internal Medicine Physician · Jacksonville, FL

NPI 1124252333 · NPPES record last updated Mar 7, 2025

Key facts

NPI
1124252333
Entity type
Organization (NPI type 2)
Primary specialty
Internal Medicine Physician 207R00000X
Legal business name
COGENT HEALTHCARE OF JACKSONVILLE, LLC
Practice address
655 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 244-3850
Fax
(904) 244-4799
NPI assigned
May 4, 2009
Organization subpart
No

Authorized official

Name
Laura Fall
Title
Manager
Phone
(253) 682-6040

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 450

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 450

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20090824000043 FL Part B Supplier - Clinic/Group Practice 1759435944 Receives reassigned benefits from 446 practitioners
3 other NPIs on this enrollment

National Provider Directory

Locations

Use Dp7170
Los Angeles, CA 90074

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X Yes
Hospitalist Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208M00000X
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363A00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X

Addresses

Primary practice location

655 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

5410 Maryland Way
Suite 300
Brentwood, TN 37027-5064
Phone (615) 377-5600

Other identifiers

IdentifierTypeStateIssuer
001651500MedicaidFL
00A4DOtherFLBLUE CROSS/BLUE SHIELD OF FLORIDA

Other providers in Jacksonville, FL

All providers in Jacksonville, FL · Internal Medicine Physician in Florida

Sources for this page

Verify at the official NPI Registry.