NPIMap

Organization Active NPI

Community Hospice of Northeast Florida Inc

Doing business as Community Palliative Consultants

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Jacksonville, FL
National Provider Identifier
1932393717
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
COMMUNITY HOSPICE OF NORTHEAST FLORIDA INC
Doing business as
Community Palliative Consultants
Practice address
4266 Sunbeam Rd
Jacksonville, FL 32257-6030
Phone
(904) 407-6231
Fax
(904) 407-6033
NPI assigned
Sep 5, 2007
Last updated
Nov 8, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY HOSPICE OF NORTHEAST FLORIDA, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Authorized official

Name
Mr. Phillip C Ward
Title
President & Ceo
Phone
(904) 268-5200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X Primary
Pediatric Hospice and Palliative Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080H0002X

Addresses

Primary practice location

4266 Sunbeam Rd
Jacksonville, FL 32257-6030

Mailing address

4266 Sunbeam Rd
Jacksonville, FL 32257-6030
Phone (904) 407-6231

Other names 1

  • Community Palliative Consultants Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090305000704 FL Part B Supplier - Clinic/Group Practice 4688629454 Receives reassigned benefits from 65 practitioners
Practice locations: Jacksonville, FL

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Community Hospice of NE FL4 organizations share this tax ID, including this one
Part of
Community Hospice of NE FL

Other organizations with this tax ID 3

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

Locations

1385 S 18TH St
Ste 101
Fernandina, FL 32034
Phone (904) 268-5200

1 Shircliff Way
Fl 4
Jacksonville, FL 32204
Phone (904) 268-5200

4201 Belfort Rd
Fl 5
Jacksonville, FL 32216
Phone (904) 268-5200

800 Prudential Dr
Bldg 5TH
Jacksonville, FL 32207
Phone (904) 268-5200

200 Health Park Blvd
St Augustine, FL 32086
Phone (904) 824-3735

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 67

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 67

NPI Registry JSON

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1932393717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4266 SUNBEAM RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322576030",
            "telephone_number": "904-407-6231",
            "fax_number": "904-407-6033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4266 SUNBEAM RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322576030",
            "telephone_number": "904-407-6231",
            "fax_number": "904-407-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HOSPICE OF NORTHEAST FLORIDA INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY HOSPICE OF NORTHEAST FLORIDA, INC",
        "enumeration_date": "2007-09-05",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "904-268-5200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Community Palliative Consultants",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Community Palliative Consultants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.