NPIMap

Organization Active NPI

Shorecoast ER SVCS Partnership LLC

  • Emergency Medicine Physician
  • Ormond Beach, FL
National Provider Identifier
1851349153
Registry record updated Dec 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
SHORECOAST ER SVCS PARTNERSHIP LLC
Practice address
264 S Atlantic Ave
Ormond Beach, FL 32176-8149
Phone
(386) 676-4260
Fax
(386) 676-4248
NPI assigned
May 5, 2006
Last updated
Dec 24, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2013

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

Authorized official

Name
Joseph H Gatewood, M.D.NPI 1063407963
Title
President
Phone
(469) 401-2386

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

264 S Atlantic Ave
Ormond Beach, FL 32176-8149

Mailing address

13737 Noel Rd
Ste 1600
Dallas, TX 75240-1331
Phone (469) 401-2386

Other identifiers 2

IdentifierTypeStateIssuer
275954300MedicaidFL
72545OtherFLBLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387843200000",
    "number": "1851349153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13737 NOEL RD",
            "address_2": "STE 1600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752401331",
            "telephone_number": "469-401-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 S ATLANTIC AVE",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321768149",
            "telephone_number": "386-676-4260",
            "fax_number": "386-676-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORECOAST ER SVCS PARTNERSHIP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2013-12-24",
        "status": "A",
        "authorized_official_last_name": "GATEWOOD",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-401-2386",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275954300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "72545",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2013; 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.