Shands Jacksonville Medical Center Inc

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

SHANDS JACKSONVILLE MEDICAL CENTER INC

Practice address

655 W 8TH St
Basement, Acc BLDG.
Jacksonville, FL 32209-6511

Phone

(904) 244-6690

Fax

(904) 244-4431

NPI assigned

Oct 10, 2006

Organization subpart

Yes

Parent organization

SHANDS JACKSONVILLE MEDICAL CENTER, INC.As reported in NPPES

Name

Mr. Michael E Gleason

Title

VP of Finance and Treasurer

Phone

(904) 244-8675

Part of

Umc Clinical Laboratory

Member of 1

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

• Shands Teaching Hospital and Clinics Inc

  • Radiology Clinic/Center
  • Ocala, FL
  • NPI 1942031232

  Member Of

  NPD member

Locations

• Shands Jacksonville Renal Dialysis Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 22, 2024.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1669560256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-8675",
            "fax_number": "904-244-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "address_2": "BASEMENT, ACC BLDG.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-6690",
            "fax_number": "904-244-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANDS JACKSONVILLE MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHANDS JACKSONVILLE MEDICAL CENTER, INC.",
        "enumeration_date": "2006-10-10",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "GLEASON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VP OF FINANCE AND TREASURER",
        "authorized_official_telephone_number": "904-244-8675",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shands Jacksonville Renal Dialysis",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shands Jacksonville Medical Center Inc
• Shands Jacksonville Medical Center Inc
• Shands Jacksonville Medical Center Inc
• Shands Jacksonville Medical Center Inc
• Shands Jacksonville Medical Center Inc
• Shands Jacksonville Medical Center Inc
• Shands Jacksonville Medical Center Inc
• Shands Jacksonville Medical Center Inc
• Shands Jacksonville Medical Center Inc
• Blair Evonne Shane

• All providers in Jacksonville, FL
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.