NPIMap

Organization Active NPI

Sacred Heart Medical Group

  • Family Medicine Physician
  • Panama City Beach, FL
National Provider Identifier
1841960135
Registry record updated Sep 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SACRED HEART MEDICAL GROUP
Practice address
11111 Panama City Beach Pkwy Ste 3
Panama City Beach, FL 32407-2448
Phone
(850) 267-1603
NPI assigned
Sep 17, 2021
Last updated
Sep 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2021

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

Authorized official

Name
Jean Vallier
Title
Director
Phone
(850) 267-1603

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

11111 Panama City Beach Pkwy Ste 3
Panama City Beach, FL 32407-2448

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623

Other names 1

  • SHMG Primary Care at Beachside Other name

National Provider Directory

National Provider Directory
Tax ID family
Sacred Heart Specialty99 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

11111 Panama City Beach Pkwy
Ste 3
Panama City Beach, FL 32407
Phone (850) 267-1603

NPI Registry JSON

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

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631836800000",
    "number": "1841960135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 PANAMA CITY BEACH PKWY STE 3",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072448",
            "telephone_number": "850-267-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRED HEART MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-17",
        "last_updated": "2021-09-17",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "VALLIER",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "850-267-1603"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHMG Primary Care at Beachside",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Panama City Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2021; 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.