NPIMap

Organization Active NPI

Collier Hma Physician Manangement, Inc.

  • Internal Medicine Physician
  • Bonita Springs, FL
National Provider Identifier
1619064813
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COLLIER HMA PHYSICIAN MANANGEMENT, INC.
Practice address
9240 Bonita Beach Rd SE
Suite 2206
Bonita Springs, FL 34135-4249
Phone
(239) 948-5505
Fax
(239) 948-5583
NPI assigned
Oct 7, 2006
Last updated
Mar 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 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 & Onboarding
Phone
(615) 465-3334

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU

Addresses

Primary practice location

9240 Bonita Beach Rd SE
Suite 2206
Bonita Springs, FL 34135-4249

Mailing address

9240 Bonita Beach Rd SE
Suite 2206
Bonita Springs, FL 34135-4249
Phone (239) 948-5505

National Provider Directory

National Provider Directory
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.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1160179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646784000000",
    "number": "1619064813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9240 BONITA BEACH RD SE",
            "address_2": "SUITE 2206",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354249",
            "telephone_number": "239-948-5505",
            "fax_number": "239-948-5583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9240 BONITA BEACH RD SE",
            "address_2": "SUITE 2206",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354249",
            "telephone_number": "239-948-5505",
            "fax_number": "239-948-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLIER HMA PHYSICIAN MANANGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-07",
        "last_updated": "2022-03-09",
        "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 & ONBOARDING",
        "authorized_official_telephone_number": "615-465-3334"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • 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.