NPIMap

Shands Jacksonville Medical Center Inc

Organization Active NPI Hematology & Oncology Physician · Jacksonville, FL

NPI 1851892467 · NPPES record last updated Jul 22, 2024

Key facts

NPI
1851892467
Entity type
Organization (NPI type 2)
Primary specialty
Hematology & Oncology Physician 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
Organization subpart
No

Authorized official

Name
Mrs. Elizabeth Goff Smith
Title
Financial Analyst
Phone
(904) 244-1888

Owned or controlled facilities with NPI records 2

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

Other NPIs on the same Medicare enrollment 1

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

Other NPIs with the same Medicare PAC ID 4

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

Practitioners 29

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

View all 29

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Uf Health Rehabilitation Hospital - North
Jacksonville, FL · CCN 103067		 Hospital 5% Or Greater Direct Ownership Interest (49%) Sep 1, 2024
Uf Health Transitional Care-Jacksonville
Jacksonville, FL · CCN 105961		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 1, 1999

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20180302000276 FL Part B Supplier - Clinic/Group Practice 2365456258 Receives reassigned benefits from 15 practitioners
1 other NPI on this enrollment
Practice locations: Jacksonville, FL; Jacksonville Beach, FL; Middleburg, FL; Orange Park, FL; Palatka, FL; Fleming Island, FL; Fernandina Beach, FL

National Provider Directory

Locations

15255 Max Leggett Pkwy
Ste 6000
Jacksonville, FL 32218
Phone (904) 427-8600

580 W 8th St
Ste 808
Jacksonville, FL 32209
Phone (904) 244-9472

720 W 8th St
Jacksonville, FL 32209
Phone (904) 798-8781

425 N Lee St
Ste 204
Jacksonville, FL 32204
Phone (904) 247-1200

7751 Baymeadows Rd E
Ste 2
Jacksonville, FL 32256
Phone (904) 427-1050

3000 Dunn Ave
Ste 68
Jacksonville, FL 32218
Phone (904) 766-7133

655 W 8th St
Fl 10
Jacksonville, FL 32209

15255 Max Leggett Pkwy
Ste 3100
Jacksonville, FL 32218
Phone (904) 383-1015

11277 New Kings Rd
Jacksonville, FL 32219
Phone (904) 244-4894

1670 St Vincents Way
Middleburg, FL 32068
Phone (904) 308-3960

2141 Loch Rane Blvd
#11611
Orange Park, FL 32073

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207RH0003X FL Yes

Addresses

Primary practice location

655 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-1888

Other practice location 1

1350 13th Ave S
Jacksonville Beach, FL 32250-3203
Phone (904) 627-2900

Other practice location 2

1250 S 18th St
Fernandina Beach, FL 32034-1902
Phone (904) 321-3500

Other practice location 3

800 Prudential Dr
Jacksonville, FL 32207-8211
Phone (904) 202-2000

Other practice location 4

3625 University Blvd S
Jacksonville, FL 32216-4207
Phone (904) 399-6111

Other practice location 5

1 Shircliff Way
Jacksonville, FL 32204-4748
Phone (904) 308-7300

Other practice location 6

4201 Belfort Rd
Jacksonville, FL 32216-5898
Phone (904) 296-3700

Other practice location 7

3599 University Blvd S
Jacksonville, FL 32216-4252
Phone (904) 345-7600

Other practice location 8

4901 Richard St
Jacksonville, FL 32207-7328
Phone (904) 737-3120

Other practice location 9

2001 Kingsley Ave
Orange Park, FL 32073-5156
Phone (907) 639-8500

Other practice location 10

1670 St Vincents Way
Middleburg, FL 32068-8447
Phone (904) 602-1000

Other practice location 11

14550 Old Saint Augustine Rd
Jacksonville, FL 32258-2460
Phone (904) 271-6000

Other practice location 12

1699 S 14TH St
Ste 1
Fernandina Beach, FL 32034-1995
Phone (904) 427-1370

Other practice location 13

2141 Loch Rane Blvd
Ste 117
Orange Park, FL 32073-4239
Phone (904) 427-1270

Other practice location 14

15255 Max Leggett Pkwy
Ste 6000 Uf Health Oncology North
Jacksonville, FL 32218-7273
Phone (904) 427-8600

Other practice location 15

425 North Lee St
Ste 204
Jacksonville, FL 32204-1127
Phone (904) 427-1200

Other practice location 16

7751 Baymeadows Rd E
Ste 205
Jacksonville, FL 32256-5836
Phone (904) 427-1050

Other practice location 17

15255 Max Leggett Pkwy
Ste 5600 Uf Health North
Jacksonville, FL 32218-7273
Phone (904) 383-1000

Other identifiers

IdentifierTypeStateIssuer
010067600MedicaidFL

Other names

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 22, 2024.

{
    "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": "193400000X SINGLE SPECIALTY  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"
        }
    ]
}

Other providers in Jacksonville, FL

All providers in Jacksonville, FL · Hematology & Oncology Physician in Florida

Sources for this page

Verify at the official NPI Registry.