NPIMap

Organization Active NPI

Cogent Healthcare of Jacksonville, LLC

  • Internal Medicine Physician
  • St Augustine, FL
National Provider Identifier
1356924526
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COGENT HEALTHCARE OF JACKSONVILLE, LLC
Practice address
400 Health Park Blvd
St Augustine, FL 32086-5784
Phone
(904) 819-5155
NPI assigned
May 4, 2021
Last updated
May 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Authorized official

Name
Melissa Harlan
Title
Director
Phone
(615) 577-6340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

400 Health Park Blvd
St Augustine, FL 32086-5784

Mailing address

5410 Maryland Way Ste 300
Brentwood, TN 37027-5339
Phone (615) 577-6340

Other identifiers 1

IdentifierTypeStateIssuer
001651555MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Cogent Healthcare of Jacksonville LLC23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1356924526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 MARYLAND WAY STE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275339",
            "telephone_number": "615-577-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865784",
            "telephone_number": "904-819-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGENT HEALTHCARE OF JACKSONVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "HARLAN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "615-577-6340"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001651555",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.