NPIMap

Organization Active NPI

First Coast Nephrology Inc

  • Nephrology Physician
  • Jacksonville, FL
National Provider Identifier
1942625520
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
FIRST COAST NEPHROLOGY INC
Practice address
4123 University Blvd S Ste E
Jacksonville, FL 32216-4320
Phone
(904) 744-7300
Fax
(904) 281-5356
NPI assigned
Feb 19, 2014
Last updated
May 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Authorized official

Name
Jamal Saliba Salameh, MDNPI 1174558753
Title
President
Phone
(904) 744-4448

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Nephrology Physician 207RN0300X NU Primary

Addresses

Primary practice location

4123 University Blvd S Ste E
Jacksonville, FL 32216-4320

Mailing address

PO Box 57189
Jacksonville, FL 32241-7189
Phone (904) 737-2722

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140313000813 FL Part B Supplier - Clinic/Group Practice 3173753126 Receives reassigned benefits from 11 practitioners
Practice locations: Jacksonville, FL; Orange Park, FL; Macclenny, FL

National Provider Directory

National Provider Directory

Locations

4123 University Blvd S
Ste E
Jacksonville, FL 32216
Phone (904) 737-2722

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714608000000",
    "number": "1942625520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 57189",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322417189",
            "telephone_number": "904-737-2722",
            "fax_number": "904-737-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 UNIVERSITY BLVD S STE E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164320",
            "telephone_number": "904-744-7300",
            "fax_number": "904-281-5356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST NEPHROLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-19",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A",
        "authorized_official_last_name": "SALAMEH",
        "authorized_official_first_name": "JAMAL",
        "authorized_official_middle_name": "SALIBA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-744-4448",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 2, 2024; 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.