NPIMap

Organization Active NPI

ER Physician Group at Jackson Hospital

  • Specialist
  • Marianna, FL
National Provider Identifier
1790732881
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
3999 Issued in FL
Legal business name
ER PHYSICIAN GROUP AT JACKSON HOSPITAL
Doing business as
Women's Healthcare of the Panhandle
Practice address
4298 5TH Ave
Marianna, FL 32446-2173
Phone
(850) 482-5787
Fax
(850) 482-8108
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Ms. Joyce Y. Al-Mateen
Title
Accounts Manager
Phone
(850) 482-5787

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 3999 FL Primary

Addresses

Primary practice location

4298 5TH Ave
Marianna, FL 32446-2173

Mailing address

4298 5TH Ave
Marianna, FL 32446-2173
Phone (850) 482-5787

Other names 1

  • Women's Healthcare of the Panhandle Doing business as

National Provider Directory

National Provider Directory
Tax ID family
ER Phy GRP at Jackson H3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1790732881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4298 5TH AVE",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462173",
            "telephone_number": "850-482-5787",
            "fax_number": "850-482-8108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4298 5TH AVE",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324462173",
            "telephone_number": "850-482-5787",
            "fax_number": "850-482-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ER PHYSICIAN GROUP AT JACKSON HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "AL-MATEEN",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "ACCOUNTS MANAGER",
        "authorized_official_telephone_number": "850-482-5787",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "3999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Women's Healthcare of the Panhandle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marianna, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.