Sunshine Medical Specialists, LLC

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

Legal business name

SUNSHINE MEDICAL SPECIALISTS, LLC

Practice address

10175 Fortune Pkwy
Jacksonville, FL 32256-6746

Phone

(904) 533-6868

NPI assigned

Oct 3, 2019

Organization subpart

No

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

Authorized official

Name

Thanh Nguyen, MDNPI 1831296656

Title

Owner

Phone

(904) 533-6868

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sunshine Medical Specialists, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thanh M Nguyen, MD

  • Pediatric Endocrinology Physician
  • Jacksonville, FL
  • NPI 1831296656

  FL, Pediatric Endocrinology

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585699200000",
    "number": "1336780907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 N KYLE WAY",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322591927",
            "telephone_number": "904-533-6868",
            "fax_number": "904-770-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 FORTUNE PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566746",
            "telephone_number": "904-533-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE MEDICAL SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-03",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "THANH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-533-6868",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103328600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sunshine Medical Specialists, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sunshine Medical Specialists, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sunshine Provider Services
• Sunshine Speech LLC
• Sunshine Spine and Pain PA

• All providers in Jacksonville, FL
• Pediatric Endocrinology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.