NPIMap

Organization Active NPI

Good Shepherd Medical Clinic PA

  • Internal Medicine Physician
  • Spring Hill, FL
National Provider Identifier
1790944858
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0071459 Issued in FL
Legal business name
GOOD SHEPHERD MEDICAL CLINIC PA
Practice address
8425 Northcliffe Blvd
Suite 110
Spring Hill, FL 34606-1107
Phone
(352) 683-5857
Fax
(352) 683-5753
NPI assigned
Jun 4, 2008
Organization subpart
Yes
Parent organization
GOOD SHEPHERD MEDICAL CLINIC PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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) 686-5023

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X ME0071459 FL Primary

Addresses

Primary practice location

8425 Northcliffe Blvd
Suite 110
Spring Hill, FL 34606-1107

Mailing address

8425 Northcliffe Blvd
Suite 110
Spring Hill, FL 34606
Phone (352) 683-5857

National Provider Directory

National Provider Directory
Part of
Nathan C Devabose MD

NPI Registry JSON

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": "1790944858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8425 NORTHCLIFFE BLVD",
            "address_2": "SUITE 110",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "34606",
            "telephone_number": "352-683-5857",
            "fax_number": "352-683-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8425 NORTHCLIFFE BLVD",
            "address_2": "SUITE 110",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346061107",
            "telephone_number": "352-683-5857",
            "fax_number": "352-683-5753"
        }
    ],
    "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": "352-686-5023",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0071459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Hill, FL

Sources for this page

  • 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.