NPIMap

Organization Active NPI

Sacred Heart Health System, Inc.

Doing business as Sacred Heart Medical Group #04

  • Orthopaedic Surgery Physician
  • Pensacola, FL
National Provider Identifier
1306363007
Registry record updated May 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SACRED HEART HEALTH SYSTEM, INC.
Doing business as
Sacred Heart Medical Group #04
Practice address
4521 N Davis Hwy
Pensacola, FL 32503-2770
Phone
(850) 494-9002
Fax
(850) 477-3912
NPI assigned
Aug 24, 2017
Last updated
May 12, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
SACRED HEART HEALTH SYSTEM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 12, 2021

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

Authorized official

Name
Miranda Hemm
Title
Enrollment Manager
Phone
(904) 450-6004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X FL Primary

Addresses

Primary practice location

4521 N Davis Hwy
Pensacola, FL 32503-2770

Mailing address

PO Box 2699
Attn: Hpe
Pensacola, FL 32513-2699
Phone (850) 475-4620

Other names 1

  • SACRED HEART MEDICAL GROUP #04 Doing business as

National Provider Directory

National Provider Directory
Part of
Sacred Heart Emerg Phys

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1306363007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2699",
            "address_2": "ATTN: HPE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325132699",
            "telephone_number": "850-475-4620",
            "fax_number": "850-475-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4521 N DAVIS HWY",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032770",
            "telephone_number": "850-494-9002",
            "fax_number": "850-477-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED HEART HEALTH SYSTEM, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SACRED HEART HEALTH SYSTEM, INC.",
        "enumeration_date": "2017-08-24",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "HEMM",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "904-450-6004"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SACRED HEART MEDICAL GROUP #04",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.