NPIMap

Organization Active NPI

Live Oak Hma, LLC

Doing business as Shands Live Oak Regional Medical Center

  • Critical Access Hospital
  • Live Oak, FL
National Provider Identifier
1255430757
Registry record updated Feb 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
4314 Issued in FL
Legal business name
LIVE OAK HMA, LLC
Doing business as
Shands Live Oak Regional Medical Center
Practice address
1100 11TH St SW
Live Oak, FL 32064-3608
Phone
(386) 362-0800
Fax
(352) 733-0069
NPI assigned
Sep 21, 2006
Last updated
Feb 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2018

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

Authorized official

Name
Paula Lalor
Title
Director/Delegated Official
Phone
(615) 925-4565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 4314 FL Primary

Addresses

Primary practice location

1100 11TH St SW
Live Oak, FL 32064-3608

Mailing address

1100 11TH St SW
Live Oak, FL 32064-3608
Phone (386) 362-0800

Other identifiers 2

IdentifierTypeStateIssuer
010179600MedicaidFL
CF9177OtherFLMEDICARE RAIL ROAD

Other names 1

  • Shands Live Oak Regional Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Shands at Starke ER Phy34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519257600000",
    "number": "1255430757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 11TH ST SW",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320643608",
            "telephone_number": "386-362-0800",
            "fax_number": "352-733-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 11TH ST SW",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320643608",
            "telephone_number": "386-362-0800",
            "fax_number": "352-733-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE OAK HMA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2018-02-22",
        "status": "A",
        "authorized_official_last_name": "LALOR",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "DIRECTOR/DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "615-925-4565"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "FL",
            "license": "4314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010179600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "CF9177",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shands Live Oak Regional Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Live Oak, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2018; 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.