NPIMap

Organization Active NPI

Sacred Heart Medical Group

  • Pediatrics Physician
  • Pensacola, FL
National Provider Identifier
1316614563
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SACRED HEART MEDICAL GROUP
Practice address
1657 Trinity Dr
Pensacola, FL 32504-5708
Phone
(850) 416-2400
NPI assigned
Aug 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Authorized official

Name
Jean Vallier
Title
Director
Phone
(850) 416-2400

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Pediatric Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0210X
Pediatric Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2088P0231X

Addresses

Primary practice location

1657 Trinity Dr
Pensacola, FL 32504-5708

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623

Other names 1

  • Pediatric Subspecialty at Trinity Other name

National Provider Directory

National Provider Directory
Tax ID family
Sacred Heart Medical Oncology Group98 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629849600000",
    "number": "1316614563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1657 TRINITY DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325045708",
            "telephone_number": "850-416-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED HEART MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A",
        "authorized_official_last_name": "VALLIER",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "850-416-2400"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology, Pediatric Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Subspecialty at Trinity",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 25, 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.