Intercoastal Health

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

INTERCOASTAL HEALTH

Practice address

3874 San Jose Park Dr Ste 5
Jacksonville, FL 32217-4660

Phone

(904) 799-2531

Fax

(904) 659-8558

NPI assigned

Dec 19, 2024

Organization subpart

No

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

Authorized official

Name

Peter Christopher McDermott, APRNNPI 1396282836

Title

Manager

Phone

(904) 799-2531

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Peter Christopher McDermott, ARNP

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1396282836
  NPD Authorized official

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

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778630400000",
    "number": "1518775873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3874 SAN JOSE PARK DR STE 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174660",
            "telephone_number": "904-799-2531",
            "fax_number": "904-659-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3874 SAN JOSE PARK DR STE 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174660",
            "telephone_number": "904-799-2531",
            "fax_number": "904-659-8558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERCOASTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-19",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A",
        "authorized_official_last_name": "MCDERMOTT",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "904-799-2531",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrity Home Care Services LLC
• Integrity Spine and Orthopedics LLC
• Intentional Play, Inc (Intentional Play Pediatric Therapy Services)
• Intercede Physical Therapy
• Intercoastal Chiropractic Clinic PA
• Internal Medical Group, Inc.
• Internal Medicine Associates of Jacksonville P a
• Internal Medicine Associates of Jacksonville, Gary a. Decker, MD, PA
• Internal Medicine of Jacksonville
• Interpreting Services Group LLC (Interpreting Services Group of Florida)

• Health Service Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2026; 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.