Good Shepherd Medical Clinic PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME44664 Issued in FL

Legal business name

GOOD SHEPHERD MEDICAL CLINIC PA

Practice address

8425 Northcliffe Blvd
Suite 109
Spring Hill, FL 34606-1107

Phone

(352) 683-1017

Fax

(352) 683-2732

NPI assigned

Jun 4, 2008

Organization subpart

Yes

Parent organization

GOOD SHEPHERD MEDICAL CLINIC PAAs reported in NPPES

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

Authorized official

Name

Dr. Roger B Lee, MD

Title

President

Phone

(352) 666-1011

Specialties & licenses 1

Addresses

Part of

Nathan C Devabose MD

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1699934752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8425 NORTHCLIFFE BLVD",
            "address_2": "SUITE 109",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346061107",
            "telephone_number": "352-683-1017",
            "fax_number": "352-683-2732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8425 NORTHCLIFFE BLVD",
            "address_2": "SUITE 109",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346061107",
            "telephone_number": "352-683-1017",
            "fax_number": "352-683-2732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD SHEPHERD MEDICAL CLINIC PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOOD SHEPHERD MEDICAL CLINIC PA",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-666-1011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME44664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Good Shepherd Medical Clinic PA
• Lisa A Gordon, PA-C
• Diana Maria Gourdet, DO

• General Practice Physician in Spring Hill, FL
• Providers in Spring Hill, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.