NPIMap

Organization Active NPI

Public Health Trust of Dade County Florida

Doing business as JMG Specialty Physicians

  • Family Medicine Physician
  • Miami, FL
National Provider Identifier
1649947185
Registry record updated Feb 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA
Doing business as
JMG Specialty Physicians
Practice address
1009 NW 5TH Ave
Miami, FL 33136-3212
Phone
(786) 466-4083
NPI assigned
Aug 24, 2021
Last updated
Feb 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2022

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

Authorized official

Name
Mark T Knight, CFO
Title
Executive VP, Cfo
Phone
(305) 585-7979

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

1009 NW 5TH Ave
Miami, FL 33136-3212

Mailing address

PO Box 12493
Miami, FL 33101-2493
Phone (305) 585-5315

Other identifiers 1

IdentifierTypeStateIssuer
000957207MedicaidFL

Other names 1

  • JMG Specialty Physicians Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2008164JMG Specialty Physicians1009 NW 5TH Ave Suite 1163, Miami, FL 33136Certificate of waiverJun 6, 2028

National Provider Directory

National Provider Directory
Tax ID family
Jackson Medical Group Plan33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

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

View all 32

Locations

1009 NW 5th Ave
Miami, FL 33136
Phone (305) 577-0093

NPI Registry JSON

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645747200000",
    "number": "1649947185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12493",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331012493",
            "telephone_number": "305-585-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 NW 5TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331363212",
            "telephone_number": "786-466-4083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HEALTH TRUST OF DADE COUNTY FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-24",
        "last_updated": "2022-02-25",
        "certification_date": "2022-02-25",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE VP, CFO",
        "authorized_official_telephone_number": "305-585-7979",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000957207",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JMG Specialty Physicians",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JMG Specialty Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.