Individual provider Active NPI

Thomas R. Virtue, M.D.

  • Obstetrics & Gynecology Physician
  • Jacksonville, FL
National Provider Identifier
1477515583
Registry record updated Feb 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
ME47147 Issued in FL
Practice address
3 Shircliff Way Ste 200
Jacksonville, FL 32204-4785
Phone
(904) 384-3699
Fax
(904) 384-8529
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X ME47147 FL Primary

Addresses

Primary practice location

3 Shircliff Way Ste 200
Jacksonville, FL 32204-4785

Mailing address

PO Box 25317
Tampa, FL 33622-5317
Phone (813) 286-0033

Other identifiers 1

IdentifierTypeStateIssuer
056810400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100610000578 FL Practitioner - Obstetrics/Gynecology 0941372833 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME47147FLMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Care Florida LLC Obstetrics & Gynecology CurrentSince Mar 1, 2019 Accepting new patients
Womens' Health Hospitalists, LLC Obstetrics & Gynecology CurrentSince Mar 1, 2019 Accepting new patients
Westside Surgery Center LLC PastSince May 20, 2008 Accepting new patients

Locations

2525 Riverside Ave
Jacksonville, FL 32204
Phone (904) 388-0704

2363 Dunn Ave
Jacksonville, FL 32218
Phone (904) 751-6030

3 Shircliff Way
Ste 200
Jacksonville, FL 32204
Phone (904) 308-6463

4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1477515583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25317",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336225317",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SHIRCLIFF WAY STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044785",
            "telephone_number": "904-384-3699",
            "fax_number": "904-384-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIRTUE",
        "first_name": "THOMAS",
        "middle_name": "R.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME47147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056810400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.