Organization Active NPI

Onsite Concierge Medicine Group LLC

  • General Practice Physician
  • Jacksonville, FL
National Provider Identifier
1356970065
Registry record updated Apr 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ONSITE CONCIERGE MEDICINE GROUP LLC
Practice address
8773 Perimeter Park CT
Jacksonville, FL 32216-1165
Phone
(704) 258-7118
NPI assigned
Apr 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2020

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

Authorized official

Name
Mr. Fernando Levar Gant
Title
President/Owner
Phone
(704) 258-7118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

8773 Perimeter Park CT
Jacksonville, FL 32216-1165

Mailing address

12403 Cadley Cir
Jacksonville, FL 32219-1862
Phone (704) 258-7118

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1585958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585958400000",
    "number": "1356970065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12403 CADLEY CIR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322191862",
            "telephone_number": "704-258-7118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8773 PERIMETER PARK CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161165",
            "telephone_number": "704-258-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONSITE CONCIERGE MEDICINE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-04",
        "last_updated": "2020-04-04",
        "certification_date": "2020-04-04",
        "status": "A",
        "authorized_official_last_name": "GANT",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_middle_name": "LEVAR",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "704-258-7118",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2020; 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.