NPIMap

Organization Active NPI

Shands Jacksonville Medical Center Inc

  • Urgent Care Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1144962408
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
SHANDS JACKSONVILLE MEDICAL CENTER INC
Practice address
655 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 244-4894
NPI assigned
Apr 8, 2022
Last updated
Apr 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Authorized official

Name
Dean Cocchi
Title
Vice President of Finance
Phone
(904) 244-5013

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

655 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-1888

Other practice location 1

11277 New Kings Road
Jacksonville, FL 32219
Phone (904) 244-4894

Other practice location 2

888 Lane Ave S
Jacksonville, FL 32205-4705
Phone (904) 244-4894

Other practice location 3

11251 Lamb Tail Lane
jacksonville, FL 32256
Phone (904) 244-4894

Other names 2

  • Shands Jacksonville Urgent Care and ER Centers Other name
  • UF Health Jacksonville Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060131000121 FL Part A Provider - Hospital 2365456258 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL; Yulee, FL; Orange Park, FL; Fernandina Beach, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1144962408. Details of each certification follow.

Hospital certification: CCN 100001

Legal name
SHANDS JACKSONVILLE MEDICAL CENTER INC
Doing business as
UF HEALTH JACKSONVILLE
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Feb 5, 2011
Beds
715
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jan 1, 1982 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1999 in FL
Enrollment address
655 W 8TH St
Jacksonville, FL 32209-6511
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Shands JacksonvilleCCN 100001 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2275121Shands Jacksonville Medical Center Inc11251 Lamb Tail LN, Jacksonville, FL 32256ComplianceMay 7, 2027
10D2277034Shands Jacksonville Medical Center Inc11277 New Kings Road, Jacksonville, FL 32219ComplianceNov 15, 2027
10D2278661Shands Jacksonville Medical Center Inc888 Lane Ave, Jacksonville, FL 32205ComplianceJul 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Shands Jacksonville7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Member of 1

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

Locations

11277 New Kings Rd
Jacksonville, FL 32219
Phone (904) 244-4894

425 N Lee St
Jacksonville, FL 32204
Phone (904) 357-3669

425 N Lee St
Ste 204
Jacksonville, FL 32204
Phone (904) 247-1200

580 W 8th St
Ste 9009
Jacksonville, FL 32209
Phone (904) 244-4027

6015 118th St
Ste 1
Jacksonville, FL 32244

655 W 8th St
Bsmt
Jacksonville, FL 32209
Phone (904) 244-6386

655 W 8th St
Fl 1
Jacksonville, FL 32209
Phone (904) 244-3817

888 Lane Ave S
Jacksonville, FL 32205
Phone (904) 244-4894

251 Breezeway St
Ste 100
Yulee, FL 32097
Phone (904) 427-8300

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Bank of America, NA Organization, New York, NY Financial institution 5% Or Greater Security Interest Nov 21, 2013 11.1%
Patrick Green Individual Corporate OfficerChief Executive Officer Jul 10, 2023
David Mann Individual Corporate DirectorDirector Jul 1, 2019
Marsha Powers Individual Corporate DirectorDirector Jul 1, 2019
Ryan Fuller Individual Corporate DirectorVoluntary Board Member Sep 26, 2024
Stephen Joel Motew Individual Corporate DirectorVoluntary Board Member Sep 26, 2024
Todd Neville Individual Corporate Director Sep 26, 2024
Gregory Lewis Individual Corporate DirectorVoluntary Board Member Sep 26, 2024
Christopher Frederick Individual Corporate OfficerInterim Chief Financial Officer Dec 19, 2025
Robert Stilley Individual Corporate DirectorVoluntary Board Member Nov 1, 2024
Kerin Da Cruz Individual Corporate OfficerChief Operating Officer (Coo) Mar 11, 2025
W-2 Managing EmployeeChief Operating Officer Mar 11, 2025 100%
Donald W Landry Individual Corporate DirectorVoluntary Board Member Sep 1, 2025
Shands Jacksonville Healthcare Inc Organization, Jacksonville, FL Non-profit Operational/Managerial Control Oct 1, 1999 100%
Edmund Hunter Beebe Individual Corporate DirectorVoluntary Board Member Sep 26, 2024
Jennifer Hunt Individual Corporate DirectorVoluntary Board Member Sep 26, 2024

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

Affiliated clinicians 1,021

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,021

NPI Registry JSON

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1144962408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-4894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11277 NEW KINGS ROAD",
            "address_purpose": "LOCATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32219",
            "country_code": "US",
            "telephone_number": "904-244-4894",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "888 Lane Ave S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322054705",
            "country_code": "US",
            "telephone_number": "904-244-4894",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11251 Lamb Tail Lane",
            "address_purpose": "LOCATION",
            "city": "jacksonville",
            "state": "FL",
            "postal_code": "32256",
            "country_code": "US",
            "telephone_number": "904-244-4894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHANDS JACKSONVILLE MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "COCCHI",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "VICE PRESIDENT OF FINANCE",
        "authorized_official_telephone_number": "904-244-5013"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shands Jacksonville Urgent Care and ER Centers",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "UF Health Jacksonville",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.