NPIMap

Organization Active NPI

Cogent Healthcare of Jacksonville, LLC

  • Internal Medicine Physician
  • Clearwater, FL
National Provider Identifier
1639835465
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
COGENT HEALTHCARE OF JACKSONVILLE, LLC
Practice address
2770 Regency Oaks Blvd
Clearwater, FL 33759-1509
Phone
(727) 791-7743
NPI assigned
Nov 16, 2021
Last updated
Nov 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Authorized official

Name
Melissa Harlan
Title
Director of Payer Enrollment
Phone
(615) 577-6340

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

2770 Regency Oaks Blvd
Clearwater, FL 33759-1509

Mailing address

5410 Maryland Way Ste 300
Brentwood, TN 37027-5339
Phone (866) 282-7905

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090824000043 FL Part B Supplier - Clinic/Group Practice 1759435944 Receives reassigned benefits from 446 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Cogent Healthcare of Jacksonville LLC23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1639835465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 MARYLAND WAY STE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275339",
            "telephone_number": "866-282-7905",
            "fax_number": "855-206-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 REGENCY OAKS BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337591509",
            "telephone_number": "727-791-7743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGENT HEALTHCARE OF JACKSONVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-16",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "HARLAN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "DIRECTOR OF PAYER ENROLLMENT",
        "authorized_official_telephone_number": "615-577-6340"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.