NPIMap

Organization Active NPI

Gulf Coast Hma Physician Management LLC

Doing business as Gulf Coast Medical Group

  • Internal Medicine Physician
  • Venice, FL
National Provider Identifier
1407806094
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GULF COAST HMA PHYSICIAN MANAGEMENT LLC
Doing business as
Gulf Coast Medical Group
Practice address
1101 Tamiami TRL S
Suite 101
Venice, FL 34285-4133
Phone
(941) 480-2831
Fax
(941) 480-2820
NPI assigned
May 12, 2006
Last updated
Mar 14, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH MANAGEMENT ASSOCIATES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Authorized official

Name
Jennifer L Jackson
Title
Sr. Director Provider Enrollment
Phone
(615) 465-3334

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X
Gastroenterology Physician 207RG0100X
Pulmonary Disease Physician 207RP1001X
Neurological Surgery Physician 207T00000X
Obstetrics & Gynecology Physician 207V00000X
Surgery Physician 208600000X
General Practice Physician 208D00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X

Addresses

Primary practice location

1101 Tamiami TRL S
Suite 101
Venice, FL 34285-4133

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (615) 465-7000

Other identifiers 1

IdentifierTypeStateIssuer
94784OtherFLBCBS GROUP PROVIDER NUMBE

Other names 1

  • Gulf Coast Medical Group Doing business as

National Provider Directory

National Provider Directory

Locations

1101 Tamiami Trl S
Ste 101
Venice, FL 34285
Phone (941) 480-1187

1211 Jacaranda Blvd
Venice, FL 34292
Phone (941) 492-2212

1700 E Venice Ave
Venice, FL 34292
Phone (941) 483-9760

1720 E Venice Ave
Fl 1
Venice, FL 34292
Phone (941) 483-9700

Practitioners & affiliated clinicians

Practitioners 60

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1407806094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "615-465-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 TAMIAMI TRL S",
            "address_2": "SUITE 101",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342854133",
            "telephone_number": "941-480-2831",
            "fax_number": "941-480-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST HMA PHYSICIAN MANAGEMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH MANAGEMENT ASSOCIATES, INC",
        "enumeration_date": "2006-05-12",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR. DIRECTOR PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "615-465-3334"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PROVIDER NUMBE",
            "identifier": "94784",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf Coast Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gulf Coast Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.