Shands Jacksonville Medical Center Inc

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

Legal business name

SHANDS JACKSONVILLE MEDICAL CENTER INC

Practice address

655 W 8TH St
Jacksonville, FL 32209-6511

Phone

(904) 244-1888

Fax

(904) 244-1959

NPI assigned

Feb 28, 2018

Last updated

Jul 22, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Elizabeth Goff Smith

Title

Financial Analyst

Phone

(904) 244-1888

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Shands Jacksonville Hematology/Oncology Physican Group Other name
• UF HEALTH JACKSONVILLE Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 4

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

• Shands Jacksonville Medical Center Inc

  dba Shands Jacksonville Ambulatory Pharmacy

  • Pharmacy
  • Jacksonville, FL
  • NPI 1639267222

  2365456258

  Same PAC ID
• Shands Jacksonville Medical Center Inc

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1669563557

  2365456258

  Same PAC ID
• Shands Jacksonville Medical Center Inc

  dba Shands Jacksonville Skilled Nursing Unit

  • Skilled Nursing Facility
  • Jacksonville, FL
  • NPI 1730277229

  2365456258

  Same PAC ID
• Shands Jacksonville Medical Center Inc

  dba Shands Jacksonville

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1821186313

  2365456258

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

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

• Shands Jacksonville Medical Center Inc

  dba Shands Jacksonville

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1821186313

  O20180302000276

  Same enrollment

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

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

• Duval Rehabilitation LLC

  dba Uf Health Rehabilitation Hospital - North

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1669232864

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Shands Jacksonville Medical Center Inc

  dba Shands Jacksonville Skilled Nursing Unit

  • Skilled Nursing Facility
  • Jacksonville, FL
  • NPI 1730277229

  5% Or Greater Direct Ownership Interest

  CMS ownership

Practitioners 29

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.

• Dimitrios Philippes Agaliotis, MD

  • Hematology & Oncology Physician
  • Fernandina Beach, FL
  • NPI 1790764272
  Medicare reassignment Care Compare group NPD
• Carlos M Castillo, MD

  • Hematology & Oncology Physician
  • Jacksonville, FL
  • NPI 1922095884
  Medicare reassignment Care Compare group NPD
• James Ryland Flythe

  • Physician Assistant
  • Jacksonville, FL
  • NPI 1942993670
  Medicare reassignment Care Compare group NPD
• Troy H Guthrie Jr., MD

  • Medical Oncology Physician
  • Jacksonville, FL
  • NPI 1073500328

  Hematology & Oncology

  Medicare reassignment Care Compare group NPD
• Peter Edward Hakos, PA-C

  • Physician Assistant
  • Jacksonville, FL
  • NPI 1942611991
  Medicare reassignment Care Compare group NPD
• Jeffrey M Harris, MD

  • Hematology & Oncology Physician
  • Orange Park, FL
  • NPI 1225025182
  Medicare reassignment Care Compare group NPD
• Jason Desmond Hew, M.D.

  • Medical Oncology Physician
  • Jacksonville, FL
  • NPI 1083904197

  Hematology & Oncology

  Medicare reassignment Care Compare group NPD
• Meet Atul Kadakia, MD

  • Hematology & Oncology Physician
  • Jacksonville, FL
  • NPI 1023470713
  Medicare reassignment Care Compare group NPD
• Marija Glodevic Kantarevic, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1609649235
  Medicare reassignment Care Compare group NPD
• Mohammad Asif Khan, M.D.

  • Medical Oncology Physician
  • Jacksonville, FL
  • NPI 1669525333
  Medicare reassignment Care Compare group NPD
• Yan G Makeyev, MD

  • Hematology & Oncology Physician
  • Orange Park, FL
  • NPI 1386812253
  Medicare reassignment Care Compare group NPD
• Joseph Mignone, MD

  • Hematology & Oncology Physician
  • Jacksonville, FL
  • NPI 1154318012
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1851892467",
    "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": "904-244-1888",
            "fax_number": "904-244-1959"
        },
        {
            "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": "904-244-1888",
            "fax_number": "904-244-1959"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 13th Ave S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322503203",
            "country_code": "US",
            "telephone_number": "904-627-2900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 S 18th St",
            "address_purpose": "LOCATION",
            "city": "Fernandina Beach",
            "state": "FL",
            "postal_code": "320341902",
            "country_code": "US",
            "telephone_number": "904-321-3500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Prudential Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078211",
            "country_code": "US",
            "telephone_number": "904-202-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3625 University Blvd S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322164207",
            "country_code": "US",
            "telephone_number": "904-399-6111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Shircliff Way",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322044748",
            "country_code": "US",
            "telephone_number": "904-308-7300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 Belfort Rd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322165898",
            "country_code": "US",
            "telephone_number": "904-296-3700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3599 University Blvd S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322164252",
            "country_code": "US",
            "telephone_number": "904-345-7600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4901 Richard St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322077328",
            "country_code": "US",
            "telephone_number": "904-737-3120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 Kingsley Ave",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320735156",
            "country_code": "US",
            "telephone_number": "907-639-8500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1670 St Vincents Way",
            "address_purpose": "LOCATION",
            "city": "Middleburg",
            "state": "FL",
            "postal_code": "320688447",
            "country_code": "US",
            "telephone_number": "904-602-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14550 Old Saint Augustine Rd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322582460",
            "country_code": "US",
            "telephone_number": "904-271-6000",
            "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": "904-427-1370",
            "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": "904-427-1270",
            "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": "904-427-8600",
            "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": "904-427-1200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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": "904-427-1050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15255 MAX LEGGETT PKWY",
            "address_2": "STE 5600 UF HEALTH NORTH",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322187273",
            "country_code": "US",
            "telephone_number": "904-383-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHANDS JACKSONVILLE MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-28",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "GOFF",
        "authorized_official_title_or_position": "FINANCIAL ANALYST",
        "authorized_official_telephone_number": "904-244-1888",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010067600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shands Jacksonville Hematology/Oncology Physican Group",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Shands Jacksonville Hematology/Oncology Physican Group",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "UF HEALTH JACKSONVILLE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Shands Jacksonville Medical Center Inc (Shands Jacksonville Ambulatory Pharmacy)
• Shands Jacksonville Medical Center Inc (Shands Jacksonville Renal Dialysis)
• Shands Jacksonville Medical Center Inc
• Shands Jacksonville Medical Center Inc (Shands Jacksonville Skilled Nursing Unit)
• Shands Jacksonville Medical Center Inc (Shands Jacksonville)
• Blair Evonne Shane
• Cameo C Shane, DNP, FNP-BC
• Katie Kris Lyn Shaneyfelt
• Julia Anne Shank, ARNP
• Rama Shankar, M.D.

• Hematology & Oncology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Hematology & Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.