NPIMap

Organization Active NPI

Good Shepherd Medical Clinic PA

  • Internal Medicine Physician
  • Spring Hill, FL
National Provider Identifier
1336301829
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0071038 Issued in FL
Legal business name
GOOD SHEPHERD MEDICAL CLINIC PA
Practice address
8425 Northcliffe Blvd
Suite 112
Spring Hill, FL 34606-1107
Phone
(352) 686-5255
Fax
(352) 666-1142
NPI assigned
Jun 26, 2008
Last updated
Jul 10, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
GOOD SHEPHERD MEDICAL CLINIC PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Dr. Roger B Lee, M.D.
Title
President
Phone
(352) 683-2495

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME0071038 FL Primary

Addresses

Primary practice location

8425 Northcliffe Blvd
Suite 112
Spring Hill, FL 34606-1107

Mailing address

8425 Northcliffe Blvd
Suite 112
Spring Hill, FL 34606-1107
Phone (352) 686-5255

National Provider Directory

National Provider Directory
Part of
Nathan C Devabose MD

NPI Registry JSON

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1336301829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8425 NORTHCLIFFE BLVD",
            "address_2": "SUITE 112",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346061107",
            "telephone_number": "352-686-5255",
            "fax_number": "352-666-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8425 NORTHCLIFFE BLVD",
            "address_2": "SUITE 112",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346061107",
            "telephone_number": "352-686-5255",
            "fax_number": "352-666-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD MEDICAL CLINIC PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOOD SHEPHERD MEDICAL CLINIC PA",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-683-2495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0071038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Hill, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.