NPIMap

Santa Rosa Hma Physician Management, LLC

Organization Active NPI Family Medicine Physician · Milton, FL

NPI 1447365366 · NPPES record last updated Aug 19, 2024

Key facts

NPI
1447365366
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
SANTA ROSA HMA PHYSICIAN MANAGEMENT, LLC
Practice address
4225 Woodbine Rd Ste a
Milton, FL 32571-8791
Phone
(850) 994-6575
Fax
(850) 994-2806
NPI assigned
Aug 20, 2006
Organization subpart
No

Authorized official

Name
Ms. Kristina Music
Title
Director Provider Enrollment
Phone
(877) 892-9815

Practitioners 99

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

View all 99

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20070823000556 FL Part B Supplier - Clinic/Group Practice 1658478532 Receives reassigned benefits from 82 practitioners
Practice locations: Milton, FL; Navarre, FL; Pace, FL; Port Charlotte, FL; Cantonment, FL; Crestview, FL

National Provider Directory

Locations

5992 Berryhill Rd
Ste 301
Milton, FL 32570
Phone (850) 416-4620

4255 Woodbine Rd Ste a
Milton, FL 32571

5992 Berryhill Rd
Ste 102
Milton, FL 32570
Phone (850) 981-3302

5992 Berryhill Rd
Ste 206
Milton, FL 32570
Phone (850) 626-5324

6007 Berryhill Rd
Milton, FL 32570
Phone (850) 623-4771

1929 Ortega St
Navarre, FL 32566
Phone (850) 626-5459

7456 Navarre Pkwy
Navarre, FL 32566
Phone (850) 626-5070

4225 Woodbine Rd
Ste A
Pace, FL 32571
Phone (850) 626-2020

1950 Laurel Manor Dr
Ste 150
The Villages, FL 32162
Phone (352) 633-5282

6209 Riverside Dr
Ste 100
Dublin, OH 43017

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207Q00000X Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207R00000X
Obstetrics & Gynecology Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 207V00000X
Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208600000X
Hospitalist Physician
Group: 193200000X MULTI-SPECIALTY GROUP		 208M00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP		 363L00000X

Addresses

Primary practice location

4225 Woodbine Rd Ste a
Milton, FL 32571-8791

Mailing address

PO Box 689022
Franklin, TN 37068-9022

Other identifiers

IdentifierTypeStateIssuer
374819701MedicaidFL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 19, 2024.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1447365366",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 WOODBINE RD STE A",
            "city": "MILTON",
            "state": "FL",
            "postal_code": "325718791",
            "telephone_number": "850-994-6575",
            "fax_number": "850-994-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA ROSA HMA PHYSICIAN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "MUSIC",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "DIRECTOR PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "877-892-9815",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374819701",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, FL

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Sources for this page

Verify at the official NPI Registry.