NPIMap

Organization Active NPI

Citrus Memorial Hospital, Inc.

Doing business as HCA Florida Black Diamond Emergency, a part of HCA Florida Citrus Hospital

  • Emergency Care Clinic/Center
  • Lecanto, FL
National Provider Identifier
1760315014
Registry record updated Jun 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
CITRUS MEMORIAL HOSPITAL, INC.
Doing business as
HCA Florida Black Diamond Emergency, a part of HCA Florida Citrus Hospital
Practice address
3470 W Norvell Bryant Hwy
Lecanto, FL 34461
Phone
(352) 513-6444
NPI assigned
Jun 5, 2026
Last updated
Jun 5, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CITRUS MEMORIAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2026

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

Authorized official

Name
Jodan Fulkerson
Title
Cfo
Phone
(727) 341-4806

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X NU Primary

Addresses

Primary practice location

3470 W Norvell Bryant Hwy
Lecanto, FL 34461

Mailing address

3470 W Norvell Bryant Hwy
Lecanto, FL 34461
Phone (352) 513-6444

Other names 1

  • HCA Florida Black Diamond Emergency, a part of HCA Florida Citrus Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

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
10D2335917HCA Florida Black Diamond Emergency3470 W Norvell Bryant Hwy, Lecanto, FL 34461RegistrationDec 18, 2027

National Provider Directory

National Provider Directory
Tax ID family
Citrus Memorial Hospital Inc5 organizations share this tax ID, including this one
Part of
Citrus Memorial Hospital Inc

Other organizations with this tax ID 4

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

Locations

3470 W Norvell Bryant Hwy
Lecanto, FL 34461
Phone (352) 513-6444

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1780617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780617600000",
    "number": "1760315014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3470 W NORVELL BRYANT HWY",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "34461",
            "telephone_number": "352-513-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3470 W NORVELL BRYANT HWY",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "34461",
            "telephone_number": "352-513-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITRUS MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CITRUS MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2026-06-05",
        "last_updated": "2026-06-05",
        "certification_date": "2026-05-27",
        "status": "A",
        "authorized_official_last_name": "FULKERSON",
        "authorized_official_first_name": "JODAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "727-341-4806"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "HCA Florida Black Diamond Emergency, a part of HCA Florida Citrus Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lecanto, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; 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.