NPIMap

Organization Active NPI

Mental Health Resource Center Inc

  • Community Health Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1851407365
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
MENTAL HEALTH RESOURCE CENTER INC
Practice address
11820 Beach Blvd
Jacksonville, FL 32246-6670
Phone
(904) 642-9100
Fax
(904) 642-9108
NPI assigned
Aug 21, 2006
Last updated
Dec 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Authorized official

Name
Robert Sommers, PH.D.
Title
President/Ceo
Phone
(904) 743-1883

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community Health Clinic/Center 261QC1500X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Psychiatric Hospital Unit 273R00000X
Psychiatric Hospital 283Q00000X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

11820 Beach Blvd
Jacksonville, FL 32246-6670

Mailing address

PO Box 19249
Jacksonville, FL 32245-9249
Phone (904) 743-1883

Other practice location 1

4427 Emerson St Ste 5
Jacksonville, FL 32207-4960
Phone (904) 745-0042

Other practice location 2

3333 W 20th St
Jacksonville, FL 32254-1703
Phone (904) 695-9145

Other identifiers 10

IdentifierTypeStateIssuer
060293100MedicaidFL
060293111MedicaidFL
060293113MedicaidFL
060293114MedicaidFL
261464200MedicaidFL
060293102MedicaidFL
060293112MedicaidFL
060293106MedicaidFL
99464OtherFLMEDICARE PART B ONLY
060293105MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040615000219 FL Part B Supplier - Clinic/Group Practice 2567446982 Receives reassigned benefits from 29 practitioners
Practice locations: Jacksonville, FL

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
10D0858348Mental Health Resource Center, Inc3333 W 20TH Street, Jacksonville, FL 32254Certificate of waiverJun 30, 2027
10D0862434Mental Health Resource Center, Inc11820 Beach Blvd, Jacksonville, FL 32246Certificate of waiverJul 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Mental Health Resource Center Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11820 Beach Blvd
Jacksonville, FL 32246
Phone (904) 642-9100

2843 University Blvd N
Jacksonville, FL 32211
Phone (904) 241-4184

3333 W 20th St
Jacksonville, FL 32254
Phone (904) 384-2364

4427 Emerson St
Ste 5
Jacksonville, FL 32207
Phone (904) 745-0042

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • HealthSun Health Plans Network
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners & affiliated clinicians

Practitioners 61

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 61

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1851407365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19249",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322459249",
            "telephone_number": "904-743-1883",
            "fax_number": "904-743-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11820 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322466670",
            "telephone_number": "904-642-9100",
            "fax_number": "904-642-9108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4427 Emerson St Ste 5",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322074960",
            "country_code": "US",
            "telephone_number": "904-745-0042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 W 20th St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322541703",
            "country_code": "US",
            "telephone_number": "904-695-9145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MENTAL HEALTH RESOURCE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "SOMMERS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "904-743-1883",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060293100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060293111",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060293113",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060293114",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "261464200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060293102",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060293112",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060293106",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B ONLY",
            "identifier": "99464",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060293105",
            "state": "FL"
        }
    ],
    "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 Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.