NPIMap

Organization Active NPI

Shands Jacksonville Medical Center Inc

Doing business as Shands Jacksonville

  • General Acute Care Hospital
  • Jacksonville, FL
National Provider Identifier
1821186313
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
4063 Issued in FL
Legal business name
SHANDS JACKSONVILLE MEDICAL CENTER INC
Doing business as
Shands Jacksonville
Practice address
655 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 244-8675
Fax
(904) 244-4027
NPI assigned
Oct 10, 2006
Last updated
Jul 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

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

Specialties & licenses 2

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

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 100
Jacksonville, FL 32207-4961
Phone (904) 244-1209

Other practice location 7

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

Other practice location 8

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

Other practice location 9

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

Other practice location 10

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

Other practice location 11

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

Other practice location 12

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

Other practice location 13

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

Other identifiers 1

IdentifierTypeStateIssuer
IP010067600MedicaidFL

Other names 1

  • Shands Jacksonville Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821186313. Details of each certification follow.

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
CorporationNon-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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Shands JacksonvilleCCN 100001 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
10D0268906Shands Jacksonville Clinical Center655 W 8TH St, Jacksonville, FL 32209AccreditationFeb 27, 2027
10D1015763Shands Jacksonville-Waive Nursing655 W 8TH St RM 1-041, Jacksonville, FL 32209Certificate of waiverAug 11, 2027

National Provider Directory

National Provider Directory

Locations

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

15255 Max Leggett Pkwy
Ste 5600
Jacksonville, FL 32218
Phone (904) 244-1209

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

4549 Emerson St
Ste 300
Jacksonville, FL 32207
Phone (904) 427-8900

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

2141 Loch Rane Blvd
Ste 117
Orange Park, FL 32073
Phone (904) 427-1270

Ownership & related parties

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 OfficerChief Executive Officer Jul 10, 2023
David Mann Individual Corporate DirectorDirector Jul 1, 2019
Marsha Powers Individual Corporate DirectorDirector Jul 1, 2019
Ryan Fuller Individual Corporate DirectorVoluntary Board Member Sep 26, 2024
Stephen Joel Motew Individual Corporate DirectorVoluntary Board Member Sep 26, 2024
Todd Neville Individual Corporate Director Sep 26, 2024
Gregory Lewis Individual Corporate DirectorVoluntary Board Member Sep 26, 2024
Christopher Frederick Individual Corporate OfficerInterim Chief Financial Officer Dec 19, 2025
Robert Stilley Individual Corporate DirectorVoluntary Board Member Nov 1, 2024
Kerin Da Cruz Individual Corporate OfficerChief Operating Officer (Coo) Mar 11, 2025
W-2 Managing EmployeeChief Operating Officer Mar 11, 2025 100%
Donald W Landry Individual Corporate DirectorVoluntary 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 DirectorVoluntary Board Member Sep 26, 2024
Jennifer Hunt Individual Corporate DirectorVoluntary Board Member Sep 26, 2024

Owners & managing parties with NPI records 3

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

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

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1,021

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

View all 1,021

NPI Registry JSON

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

{
    "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 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"
        },
        {
            "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": "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": "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": "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": "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"
        }
    ],
    "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

Sources for this page

Verify at the official NPI Registry.