NPIMap

Organization Active NPI

Tallahassee Memorial Healthcare Inc

  • Internal Medicine Physician
  • Tallahassee, FL
National Provider Identifier
1487932422
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TALLAHASSEE MEMORIAL HEALTHCARE INC
Practice address
1300 Medical Dr
Tallahassee, FL 32308-4646
Phone
(850) 216-0190
Fax
(850) 216-0112
NPI assigned
Jul 25, 2011
Last updated
Jan 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Authorized official

Name
Mr. Robin L. Moss
Title
Executive Director
Phone
(850) 431-6256

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X FL Primary
Cardiovascular Disease Physician 207RC0000X FL
Clinical Cardiac Electrophysiology Physician 207RC0001X FL
Interventional Cardiology Physician 207RI0011X FL
Physician Assistant 363A00000X FL
Nurse Practitioner 363L00000X FL

Addresses

Primary practice location

1300 Medical Dr
Tallahassee, FL 32308-4646

Mailing address

1607 Saint James CT Ste 1
Tallahassee, FL 32308-5352
Phone (850) 431-7021

Other practice location 1

555 N Byron Butler Pkwy
Perry, FL 32347-2315
Phone (850) 584-3090

Other practice location 2

333 N Byron Butler Pkwy
Perry, FL 32347-2300
Phone (850) 216-0100

Other identifiers 2

IdentifierTypeStateIssuer
24766TOtherFLBLUE CROSS BLUE SHIELD
375270421MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031222000279 FL Part B Supplier - Clinic/Group Practice 6103724778 Receives reassigned benefits from 702 practitioners
39 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tallahassee, FL; Blountstown, FL; Chipley, FL; Crawfordville, FL; Madison, FL; Marianna, FL; Monticello, FL; Panama City Beach, FL…

Other NPIs on the same Medicare enrollment 39

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 39

National Provider Directory

National Provider Directory

Locations

1300 Miccosukee Rd
Ste G
Tallahassee, FL 32308
Phone (850) 431-6315

Interoperability endpoints

  • Direct secure messaging: aaronwalker@tmhpp.allscriptsdirect.net
  • Direct secure messaging: abelromerocorral@tmhpp.allscriptsdirect.net
  • Direct secure messaging: alexandrawright@tmhpp.allscriptsdirect.net
  • Direct secure messaging: amandabrock@tmhpp.allscriptsdirect.net
  • Direct secure messaging: angelinacain@tmhpp.allscriptsdirect.net
  • Direct secure messaging: anjuagarwal@tmhpp.allscriptsdirect.net
  • Direct secure messaging: anthonyrussell@tmhpp.allscriptsdirect.net
  • Direct secure messaging: anthonyvara@tmhpp.allscriptsdirect.net
  • Direct secure messaging: antonikafrounigerges@tmhpp.allscriptsdirect.net
  • Direct secure messaging: anuragsingh@tmhpp.allscriptsdirect.net
  • Direct secure messaging: ardythemcdowell@tmhpp.allscriptsdirect.net
  • Direct secure messaging: ashley.fleming@tmhpp.allscriptsdirect.net
  • Direct secure messaging: ashleyduke@tmhpp.allscriptsdirect.net
  • Direct secure messaging: ashleyjanney@tmhpp.allscriptsdirect.net
  • Direct secure messaging: bayardmiller@tmhpp.allscriptsdirect.net
  • Direct secure messaging: beatrizcepedavalery@tmhpp.allscriptsdirect.net
  • Direct secure messaging: bonclarke@tmhpp.allscriptsdirect.net
  • Direct secure messaging: brandithompson@tmhpp.allscriptsdirect.net
  • Direct secure messaging: bretthoward@tmhpp.allscriptsdirect.net
  • Direct secure messaging: briandeem@tmhpp.allscriptsdirect.net

Practitioners & affiliated clinicians

Practitioners 161

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 161

NPI Registry JSON

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642550400000",
    "number": "1487932422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 SAINT JAMES CT STE 1",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085352",
            "telephone_number": "850-431-7021",
            "fax_number": "850-431-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MEDICAL DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084646",
            "telephone_number": "850-216-0190",
            "fax_number": "850-216-0112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 N Byron Butler Pkwy",
            "address_purpose": "LOCATION",
            "city": "Perry",
            "state": "FL",
            "postal_code": "323472315",
            "country_code": "US",
            "telephone_number": "850-584-3090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 N Byron Butler Pkwy",
            "address_purpose": "LOCATION",
            "city": "Perry",
            "state": "FL",
            "postal_code": "323472300",
            "country_code": "US",
            "telephone_number": "850-216-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TALLAHASSEE MEMORIAL HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-25",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "850-431-6256",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "24766T",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375270421",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.