Collier Hma Physician Management LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

COLLIER HMA PHYSICIAN MANAGEMENT LLC

Doing business as

Collier HMA Physician Management LLC
Physicians Regional Medical Center - Collier Boulevard

Practice address

8300 Collier Blvd
Naples, FL 34114-3549

Phone

(239) 348-4421

Fax

(239) 348-4529

NPI assigned

Jul 14, 2021

Last updated

Mar 9, 2022By the provider in NPPES

Organization subpart

No

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 15

Addresses

Other identifiers 1

Other names 2

• Collier HMA Physician Management LLC Doing business as
• Physicians Regional Medical Center - Collier Boulevard Doing business as

Tax ID family

Collier Hma Physician Management LLC37 organizations share this tax ID, including this one

Other organizations with this tax ID 36

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

• Collier Hma Physician Management LLC

  • Vascular Surgery Physician
  • Naples, FL
  • NPI 1003484890
  NPD tax ID
• Collier Hma Physician Management LLC

  • Family Medicine Physician
  • Naples, FL
  • NPI 1023955879
  NPD tax ID
• Collier Hma Physician Management LLC

  • Internal Medicine Physician
  • Bonita Springs, FL
  • NPI 1053056176
  NPD tax ID
• Collier Hma Physician Management LLC

  • Orthopaedic Surgery Physician
  • Naples, FL
  • NPI 1063082758
  NPD tax ID
• Collier Hma Physician Management LLC

  • Internal Medicine Physician
  • Naples, FL
  • NPI 1073186227
  NPD tax ID
• Collier Hma Physician Management LLC

  dba Physicians Regional Medical Group

  • Internal Medicine Physician
  • Marco Island, FL
  • NPI 1124696000
  NPD tax ID
• Collier Hma Physician Management LLC

  dba Physicians Regional Medical Group

  • Orthopaedic Surgery Physician
  • Naples, FL
  • NPI 1124696919
  NPD tax ID
• Collier Hma Physician Management LLC

  • Neurology Physician
  • Naples, FL
  • NPI 1124819172
  NPD tax ID
• Collier Hma Physician Management LLC

  • Internal Medicine Physician
  • Naples, FL
  • NPI 1154066462
  NPD tax ID
• Collier Hma Physician Management LLC

  dba Physicians Regional Medical Group

  • Pain Medicine Physician
  • Estero, FL
  • NPI 1164090874
  NPD tax ID
• Collier Hma Physician Management LLC

  • Internal Medicine Physician
  • Naples, FL
  • NPI 1194393959
  NPD tax ID
• Collier Hma Physician Management LLC

  • Family Medicine Physician
  • Naples, FL
  • NPI 1245103472
  NPD tax ID

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646784000000",
    "number": "1578135083",
    "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": "8300 COLLIER BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341143549",
            "telephone_number": "239-348-4421",
            "fax_number": "239-348-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIER HMA PHYSICIAN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "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": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0004X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Collier HMA Physician Management LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Physicians Regional Medical Center - Collier Boulevard",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Physicians Regional Medical Center - Collier Boulevard",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Collier Hma Physician Management LLC
• Collier Hma Physician Management LLC
• Collier Hma Physician Management LLC
• Collier Hma Physician Management LLC
• Collier Hma Physician Management LLC
• Collier Hma Physician Management LLC
• Collier Hma Physician Management LLC
• Collier Hma Physician Management LLC (Physicians Regional Medical Group)
• Collier Hma Physician Management LLC
• Collier Hma Physician Management LLC

• Internal Medicine Physician in Naples, FL
• Providers in Naples, FL by specialty
• Internal Medicine Physician in Florida

• 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.