NPIMap

Organization Active NPI

Symphony Specialty Group, LLC

  • Specialist
  • Jacksonville, FL
National Provider Identifier
1831878735
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SYMPHONY SPECIALTY GROUP, LLC
Practice address
8613 Old Kings Rd S Ste 602
Jacksonville, FL 32217-4863
Phone
(904) 493-3390
Fax
(904) 493-3395
NPI assigned
Jul 17, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Authorized official

Name
Andrew Escamilla
Title
Ceo
Phone
(904) 493-3390

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Pain Management Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0000X
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X

Addresses

Primary practice location

8613 Old Kings Rd S Ste 602
Jacksonville, FL 32217-4863

Mailing address

8613 Old Kings Rd S Ste 602
Jacksonville, FL 32217-4863
Phone (904) 493-3390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230823000498 FL Part B Supplier - Clinic/Group Practice 7719340850 Receives reassigned benefits from 25 practitioners
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 120

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

View all 120

NPI Registry JSON

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1831878735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8613 OLD KINGS RD S STE 602",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174863",
            "telephone_number": "904-493-3390",
            "fax_number": "904-493-3395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8613 OLD KINGS RD S STE 602",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174863",
            "telephone_number": "904-493-3390",
            "fax_number": "904-493-3395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYMPHONY SPECIALTY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A",
        "authorized_official_last_name": "ESCAMILLA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-493-3390"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Pain Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.