NPIMap

Organization Active NPI

Brooksville Hma Physician Management LLC

  • Internal Medicine Physician
  • Spring Hill, FL
National Provider Identifier
1922678663
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BROOKSVILLE HMA PHYSICIAN MANAGEMENT LLC
Doing business as
Brooksville HMA Physician Management LLC
Practice address
8425 Northcliffe Blvd Ste 112
Spring Hill, FL 34606-1107
Phone
(352) 686-5255
Fax
(352) 686-1142
NPI assigned
Jun 25, 2021
Last updated
Mar 9, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Authorized official

Name
Jennifer L Jackson
Title
Sr Dir Prov Enrollment & Onboarding
Phone
(615) 465-3334

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

8425 Northcliffe Blvd Ste 112
Spring Hill, FL 34606-1107

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (615) 465-7211

Other identifiers 1

IdentifierTypeStateIssuer
002631018MedicaidFL

Other names 1

  • Brooksville HMA Physician Management LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Brooksville Hma Physician Management LLC29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646784000000",
    "number": "1922678663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "615-465-7211",
            "fax_number": "615-628-6877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8425 NORTHCLIFFE BLVD STE 112",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346061107",
            "telephone_number": "352-686-5255",
            "fax_number": "352-686-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSVILLE HMA PHYSICIAN MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-25",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SR DIR PROV ENROLLMENT & ONBOARDING",
        "authorized_official_telephone_number": "615-465-3334"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002631018",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brooksville HMA Physician Management LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brooksville HMA Physician Management LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Spring Hill, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.