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Shands Jacksonville Medical Center Inc

Organization Active NPI General Acute Care Hospital · Jacksonville, FL

NPI 1821186313 · NPPES record last updated Jul 22, 2024

Key facts

NPI
1821186313
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
License
4063 (FL)
Legal business name
SHANDS JACKSONVILLE MEDICAL CENTER INC
Practice address
655 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 244-8675
Fax
(904) 244-4027
NPI assigned
Oct 10, 2006
Organization subpart
No

Authorized official

Name
Mr. Dean Cocchi
Title
Chief Financial Officer
Phone
(904) 244-5013

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Member of 1

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

Facilities with the same owner 2

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1,021

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 1,021

Medicare Care Compare: Hospital

Listed as
Shands Jacksonville CCN 100001
Overall star rating
★★★★☆ 4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0268906Shands Jacksonville Clinical Center
655 W 8TH St, Jacksonville, FL 32209		AccreditationFeb 27, 2027
10D1015763Shands Jacksonville-Waive Nursing
655 W 8TH St RM 1-041, Jacksonville, FL 32209		Certificate of waiverAug 11, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in FL

Hospital certification: CCN 100001

Legal name
SHANDS JACKSONVILLE MEDICAL CENTER INC
Doing business as
UF HEALTH JACKSONVILLE
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Feb 5, 2011
Beds
715
Ownership / control type
Private (not for profit)
Most recent change of ownership
Jan 1, 1982 (1 total)
Organization structure
Corporation · Non-profit
Incorporated
Oct 1, 1999 in FL
Enrollment address
655 W 8TH St
Jacksonville, FL 32209-6511
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Bank of America, NA
Organization · New York, NY
Financial institution 		5% Or Greater Security Interest Nov 21, 2013 11.1%
Patrick Green
Individual 		Corporate Officer
Chief Executive Officer		 Jul 10, 2023
David Mann
Individual 		Corporate Director
Director		 Jul 1, 2019
Marsha Powers
Individual 		Corporate Director
Director		 Jul 1, 2019
Ryan Fuller
Individual 		Corporate Director
Voluntary Board Member		 Sep 26, 2024
Stephen Joel Motew
Individual 		Corporate Director
Voluntary Board Member		 Sep 26, 2024
Todd Neville
Individual 		Corporate Director Sep 26, 2024
Gregory Lewis
Individual 		Corporate Director
Voluntary Board Member		 Sep 26, 2024
Christopher Frederick
Individual 		Corporate Officer
Interim Chief Financial Officer		 Dec 19, 2025
Robert Stilley
Individual 		Corporate Director
Voluntary Board Member		 Nov 1, 2024
Kerin Da Cruz
Individual 		Corporate Officer
Chief Operating Officer (Coo)		 Mar 11, 2025
W-2 Managing Employee
Chief Operating Officer		 Mar 11, 2025 100%
Donald W Landry
Individual 		Corporate Director
Voluntary Board Member		 Sep 1, 2025
Shands Jacksonville Healthcare Inc
Organization · Jacksonville, FL
Non-profit 		Operational/Managerial Control Oct 1, 1999 100%
Edmund Hunter Beebe
Individual 		Corporate Director
Voluntary Board Member		 Sep 26, 2024
Jennifer Hunt
Individual 		Corporate Director
Voluntary Board Member		 Sep 26, 2024

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Uf Health Rehabilitation Hospital - North
Jacksonville, FL · CCN 103067		 Hospital 5% Or Greater Direct Ownership Interest (49%) Sep 1, 2024
Uf Health Transitional Care-Jacksonville
Jacksonville, FL · CCN 105961		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 1999

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20060131000121 FL Part a Provider - Hospital 2365456258 1 other NPI on this enrollment
Practice locations: Jacksonville, FL; Yulee, FL; Orange Park, FL; Fernandina Beach, FL
O20180302000276 FL Part B Supplier - Clinic/Group Practice 2365456258 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL; Jacksonville Beach, FL; Middleburg, FL; Orange Park, FL; Palatka, FL; Fleming Island, FL; Fernandina Beach, FL

National Provider Directory

Locations

4549 Emerson St
Ste 100
Jacksonville, FL 32207
Phone (904) 244-1209

15255 Max Leggett Pkwy
Ste 1
Jacksonville, FL 32218
Phone (904) 244-1209

655 W 8th St
#1
Jacksonville, FL 32209
Phone (904) 244-5044

7751 Baymeadows Rd E
Ste 205
Jacksonville, FL 32256
Phone (904) 427-1050

15255 Max Leggett Pkwy
Ste 4100
Jacksonville, FL 32218
Phone (904) 427-1179

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X
General Acute Care Hospital 282N00000X 4063 FL Yes

Addresses

Primary practice location

655 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-8675

Other practice location 1

7751 Baymeadows Rd E
Ste 205
Jacksonville, FL 32256-5836
Phone (904) 244-1209

Other practice location 2

15255 Max Leggett Pkwy
Ste 4100
Jacksonville, FL 32218-7273
Phone (904) 244-3477

Other practice location 3

15255 Max Leggett Pkwy
1St and 2ND Floors Medical Office Building
Jacksonville, FL 32218-7273
Phone (904) 244-1209

Other practice location 4

15255 Max Leggett Pkwy
Ste 5600 Uf Health Sleep Center North
Jacksonville, FL 32218-7273
Phone (904) 244-1209

Other practice location 5

15255 Max Leggett Pkwy
Ste 6000 Uf Health Oncology North
Jacksonville, FL 32218-7273
Phone (904) 244-3477

Other practice location 6

4549 Emerson St
Building 2 Ste 300
Jacksonville, FL 32207-4961
Phone (904) 244-3477

Other practice location 7

425 North Lee St
Ste 204
Jacksonville, FL 32204-1127
Phone (904) 277-3477

Other practice location 8

1699 S 14TH St
Ste 1
Fernandina Beach, FL 32034-1995
Phone (904) 244-3477

Other practice location 9

1122 W 11TH St
Jacksonville, FL 32209-6511
Phone (904) 244-1209

Other practice location 10

3465 Village Center Dr
Jacksonville, FL 32206-8617
Phone (904) 244-1209

Other practice location 11

1155 East 21St St
Jacksonville, FL 32206-2401
Phone (904) 244-1209

Other practice location 12

4549 Emerson St
Building 2 Ste 100
Jacksonville, FL 32207-4961
Phone (904) 244-1209

Other practice location 13

2141 Loch Rane Blvd
Ste 117
Orange Park, FL 32073-4239
Phone (904) 244-3477

Other identifiers

IdentifierTypeStateIssuer
IP010067600MedicaidFL

Other names

  • Shands Jacksonville Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 22, 2024.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1821186313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-8675",
            "fax_number": "904-244-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-8675",
            "fax_number": "904-244-4027"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7751 BAYMEADOWS RD E",
            "address_2": "STE 205",
            "address_purpose": "LOCATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565836",
            "country_code": "US",
            "telephone_number": "904-244-1209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15255 MAX LEGGETT PKWY",
            "address_2": "STE 4100",
            "address_purpose": "LOCATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187273",
            "country_code": "US",
            "telephone_number": "904-244-3477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15255 MAX LEGGETT PKWY",
            "address_2": "1ST AND 2ND FLOORS MEDICAL OFFICE BUILDING",
            "address_purpose": "LOCATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187273",
            "country_code": "US",
            "telephone_number": "904-244-1209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15255 MAX LEGGETT PKWY",
            "address_2": "STE 5600 UF HEALTH SLEEP CENTER NORTH",
            "address_purpose": "LOCATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187273",
            "country_code": "US",
            "telephone_number": "904-244-1209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15255 MAX LEGGETT PKWY",
            "address_2": "STE 6000 UF HEALTH ONCOLOGY NORTH",
            "address_purpose": "LOCATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187273",
            "country_code": "US",
            "telephone_number": "904-244-3477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4549 EMERSON ST",
            "address_2": "BUILDING 2 STE 300",
            "address_purpose": "LOCATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074961",
            "country_code": "US",
            "telephone_number": "904-244-3477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 NORTH LEE ST",
            "address_2": "STE 204",
            "address_purpose": "LOCATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041127",
            "country_code": "US",
            "telephone_number": "904-277-3477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1699 S 14TH ST",
            "address_2": "STE 1",
            "address_purpose": "LOCATION",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320341995",
            "country_code": "US",
            "telephone_number": "904-244-3477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1122 W 11TH ST",
            "address_purpose": "LOCATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-244-1209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3465 VILLAGE CENTER DR",
            "address_purpose": "LOCATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322068617",
            "country_code": "US",
            "telephone_number": "904-244-1209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1155 EAST 21ST ST",
            "address_purpose": "LOCATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322062401",
            "country_code": "US",
            "telephone_number": "904-244-1209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4549 EMERSON ST",
            "address_2": "BUILDING 2 STE 100",
            "address_purpose": "LOCATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074961",
            "country_code": "US",
            "telephone_number": "904-244-1209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2141 LOCH RANE BLVD",
            "address_2": "STE 117",
            "address_purpose": "LOCATION",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734239",
            "country_code": "US",
            "telephone_number": "904-244-3477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHANDS JACKSONVILLE MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2024-07-22",
        "certification_date": "2023-09-21",
        "status": "A",
        "authorized_official_last_name": "COCCHI",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "904-244-5013",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "FL",
            "license": "4063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "IP010067600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shands Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shands Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

All providers in Jacksonville, FL · General Acute Care Hospital in Florida

Sources for this page

Verify at the official NPI Registry.