NPIMap

Organization Active NPI

Brooksville Hma Physician Management LLC

  • Obstetrics & Gynecology Physician
  • Spring Hill, FL
National Provider Identifier
1497322754
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
BROOKSVILLE HMA PHYSICIAN MANAGEMENT LLC
Practice address
11175 County Line Rd
Spring Hill, FL 34609-5615
Phone
(352) 686-8888
Fax
(352) 684-6888
NPI assigned
Jun 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 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 Dir Prov Enrollment & Onboarding
Phone
(615) 465-3334

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X Primary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207VF0040X
Obstetrics & Gynecology Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LX0001X

Addresses

Primary practice location

11175 County Line Rd
Spring Hill, FL 34609-5615

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (615) 465-7211

Other identifiers 1

IdentifierTypeStateIssuer
002631007MedicaidFL

Other names 1

  • Brooksville HMA Physician Management LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brooksville Hma Physician Management LLC29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646784000000",
    "number": "1497322754",
    "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": "615-465-7211",
            "fax_number": "615-628-6877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11175 COUNTY LINE RD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346095615",
            "telephone_number": "352-686-8888",
            "fax_number": "352-684-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSVILLE HMA PHYSICIAN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-07",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR DIR PROV ENROLLMENT & ONBOARDING",
        "authorized_official_telephone_number": "615-465-3334"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002631007",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brooksville HMA Physician Management LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brooksville HMA Physician Management LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spring Hill, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.