Organization Active NPI

Jose M. Gomez M.D. P.a.

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Jacksonville, FL
National Provider Identifier
1639363989
Registry record updated Aug 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
Legal business name
JOSE M. GOMEZ M.D. P.A.
Practice address
6817 Southpoint Pkwy
Suite 2303
Jacksonville, FL 32216-6282
Phone
(904) 332-7431
Fax
(904) 332-7408
NPI assigned
Aug 30, 2007
Last updated
Aug 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2007

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

Authorized official

Name
Jose M. Gomez, M.D.NPI 1811929532
Title
President
Phone
(904) 332-7431

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X Primary

Addresses

Primary practice location

6817 Southpoint Pkwy
Suite 2303
Jacksonville, FL 32216-6282

Mailing address

6817 Southpoint Pkwy
Suite 2303
Jacksonville, FL 32216-6282
Phone (904) 332-7431

National Provider Directory

National Provider Directory

Locations

6817 Southpoint Pkwy
Ste 2303
Jacksonville, FL 32216
Phone (904) 332-7431

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188432000000",
    "number": "1639363989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY",
            "address_2": "SUITE 2303",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166282",
            "telephone_number": "904-332-7431",
            "fax_number": "904-332-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY",
            "address_2": "SUITE 2303",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166282",
            "telephone_number": "904-332-7431",
            "fax_number": "904-332-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSE M. GOMEZ M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2007-08-30",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-332-7431",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; 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.