NPIMap

Organization Active NPI

Public Health Trust of Miami Dade County Florida

Doing business as JMG Specialty Physicians

  • Psychologist
  • Miami, FL
National Provider Identifier
1861151342
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA
Doing business as
JMG Specialty Physicians
Practice address
1611 NW 12TH Ave
Miami, FL 33136-1005
Phone
(305) 355-7147
NPI assigned
Dec 13, 2021
Last updated
Dec 13, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Authorized official

Name
Mark T Knight, CFO
Title
Executive VP, Cfo
Phone
(305) 585-8490

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

1611 NW 12TH Ave
Miami, FL 33136-1005

Mailing address

PO Box 12493
Miami, FL 33101-2493
Phone (305) 585-5315

Other identifiers 1

IdentifierTypeStateIssuer
106118200MedicaidFL

Other names 1

  • JMG Specialty Physicians Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Jackson Medical Group Plan33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1861151342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12493",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331012493",
            "telephone_number": "305-585-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 NW 12TH AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331361005",
            "telephone_number": "305-355-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HEALTH TRUST OF MIAMI DADE COUNTY FLORIDA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-10",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "EXECUTIVE VP, CFO",
        "authorized_official_telephone_number": "305-585-8490",
        "authorized_official_credential": "CFO"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106118200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JMG Specialty Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.