NPIMap

Organization Active NPI

Gulf Coast Hma Physician Management LLC

  • Registered Dietitian
  • Venice, FL
National Provider Identifier
1558745463
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND6940 Issued in FL
Legal business name
GULF COAST HMA PHYSICIAN MANAGEMENT LLC
Practice address
1370 E Venice Ave
Ste 205
Venice, FL 34285-9082
Phone
(941) 800-4700
Fax
(941) 800-4711
NPI assigned
Jul 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 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
Phone
(615) 465-3334

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193200000X MULTI-SPECIALTY GROUP 133V00000X ND6940 FL Primary

Addresses

Primary practice location

1370 E Venice Ave
Ste 205
Venice, FL 34285-9082

Mailing address

1370 E Venice Ave
Ste 205
Venice, FL 34285-9082
Phone (941) 800-4700

National Provider Directory

National Provider Directory
Tax ID family
Gulf Coast Hma Physician Management LLC44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

Locations

1370 E Venice Ave
Ste 205
Venice, FL 34285
Phone (941) 800-4700

NPI Registry JSON

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1558745463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 E VENICE AVE",
            "address_2": "STE 205",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342859082",
            "telephone_number": "941-800-4700",
            "fax_number": "941-800-4711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 E VENICE AVE",
            "address_2": "STE 205",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342859082",
            "telephone_number": "941-800-4700",
            "fax_number": "941-800-4711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST HMA PHYSICIAN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-10",
        "last_updated": "2022-03-15",
        "certification_date": "2022-02-14",
        "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",
        "authorized_official_telephone_number": "615-465-3334"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND6940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.