NPIMap

Organization Active NPI

Ascension Sacred Heart Gulf

  • Internal Medicine Physician
  • Port St Joe, FL
National Provider Identifier
1508537424
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ASCENSION SACRED HEART GULF
Practice address
3871 E Highway 98 Ste 203
Port St Joe, FL 32456-5302
Phone
(850) 229-5601
Fax
(850) 229-5696
NPI assigned
Sep 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Authorized official

Name
Miranda Hemm
Title
Enrollment Manager
Phone
(850) 229-5601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3871 E Highway 98 Ste 203
Port St Joe, FL 32456-5302

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623

Other names 1

  • SHMGG Port St. Joe Primary Care Other name

National Provider Directory

National Provider Directory
Tax ID family
Sacred Heart Hospital10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

3871 E Highway 98
Ste 203
Port St Joe, FL 32456
Phone (850) 229-5661

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632182400000",
    "number": "1508537424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3871 E HIGHWAY 98 STE 203",
            "city": "PORT ST JOE",
            "state": "FL",
            "postal_code": "324565302",
            "telephone_number": "850-229-5601",
            "fax_number": "850-229-5696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION SACRED HEART GULF",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A",
        "authorized_official_last_name": "HEMM",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "850-229-5601"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHMGG Port St. Joe Primary Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port St Joe, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.