NPIMap

Organization Active NPI

Ascension Sacred Heart Gulf

Doing business as Ascension Medical Group Sacred Heart Gulf

  • Family Medicine Physician
  • Pensacola, FL
National Provider Identifier
1528336302
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ASCENSION SACRED HEART GULF
Doing business as
Ascension Medical Group Sacred Heart Gulf
Practice address
5225 Carmel Heights Dr
Pensacola, FL 32504-8715
Phone
(850) 475-4500
Fax
(850) 475-4771
NPI assigned
Dec 7, 2011
Last updated
Oct 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Authorized official

Name
Mrs. Miranda Hemm
Title
Enrollment Manager
Phone
(904) 450-6004

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X
Pediatrics Physician 208000000X

Addresses

Primary practice location

5225 Carmel Heights Dr
Pensacola, FL 32504-8715

Mailing address

PO Box 18992
Belfast, ME 04915-4084
Phone (850) 475-4620

Other names 1

  • Ascension Medical Group Sacred Heart Gulf Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120302000494 FL Part B Supplier - Clinic/Group Practice 9830231034 Receives reassigned benefits from 23 practitioners
Practice locations: Apalachicola, FL; Port St Joe, FL; Wewahitchka, FL

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

55 Avenue E
Apalachicola, FL 32320
Phone (850) 370-1000

12905 Panama City Beach Pkwy
Panama City Beach, FL 32407

5149 N 9th Ave
Ste 246
Pensacola, FL 32504
Phone (850) 416-1080

3871 E Highway 98
Ste 302
Port Saint Joe, FL 32456

3871 E Highway 98
Ste 200
Port St Joe, FL 32456
Phone (850) 229-5661

805 Highway 22
Wewahitchka, FL 32465
Phone (850) 568-1053

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ascension Sacred Heart GulfPort St Joe, FL, CCN 10U313 Hospital 5% Or Greater Direct Ownership Interest Mar 15, 2010
Ascension Sacred Heart GulfApalachicola, FL, CCN 103452 Rural health clinic Operational/Managerial Control (100%) Feb 1, 2012
Ascension Medical Group Sacred Heart GulfWewahitchka, FL, CCN 108500 Rural health clinic Operational/Managerial Control (100%) Feb 1, 2012
Ascension Medical Group Sacred Heart GulfPort St Joe, FL, CCN 103461 Rural health clinic Operational/Managerial Control (100%) Feb 1, 2012

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 32

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 32

NPI Registry JSON

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728518400000",
    "number": "1528336302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18992",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154084",
            "telephone_number": "850-475-4620",
            "fax_number": "850-475-4619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 CARMEL HEIGHTS DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325048715",
            "telephone_number": "850-475-4500",
            "fax_number": "850-475-4771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION SACRED HEART GULF",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-07",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A",
        "authorized_official_last_name": "HEMM",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "904-450-6004",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Medical Group Sacred Heart Gulf",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.