Organization Active NPI

Gulf Coast Hma Physician Management LLC

Doing business as Englewood Primary Care & Walk In

  • Family Medicine Physician
  • Englewood, FL
National Provider Identifier
1699072934
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GULF COAST HMA PHYSICIAN MANAGEMENT LLC
Doing business as
Englewood Primary Care & Walk In
Practice address
250 W Dearborn St
Englewood, FL 34223-3245
Phone
(941) 473-5100
Fax
(941) 473-5155
NPI assigned
Feb 23, 2011
Organization subpart
Yes
Parent organization
HEALTH MANAGEMENT ASSOCIATES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Authorized official

Name
Ms. Jennifer L Jackson
Title
Senior Director Provider Enrollment
Phone
(615) 465-3334

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

250 W Dearborn St
Englewood, FL 34223-3245

Mailing address

5811 Pelican Bay Blvd
Suite 500
Naples, FL 34108-2733
Phone (239) 598-3131

Other names 1

  • Englewood Primary Care & Walk In Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gulf Coast Hma Physician Management LLC44 organizations share this tax ID, including this one

Other organizations with this tax ID 43

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

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1699072934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5811 PELICAN BAY BLVD",
            "address_2": "SUITE 500",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341082733",
            "telephone_number": "239-598-3131",
            "fax_number": "239-592-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W DEARBORN ST",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342233245",
            "telephone_number": "941-473-5100",
            "fax_number": "941-473-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST HMA PHYSICIAN MANAGEMENT LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH MANAGEMENT ASSOCIATES, INC",
        "enumeration_date": "2011-02-23",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SENIOR DIRECTOR PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "615-465-3334",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Englewood Primary Care & Walk In",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Englewood Primary Care & Walk In",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Englewood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.