Organization Active NPI

Boca Grande Health Clinic

  • Family Medicine Physician
  • Boca Grande, FL
National Provider Identifier
1972683910
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BOCA GRANDE HEALTH CLINIC
Practice address
280 Park Avenue
Boca Grande, FL 33921
Phone
(941) 964-2276
Fax
(941) 964-0158
NPI assigned
Oct 16, 2006
Last updated
May 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Authorized official

Name
Jonna R Foos
Title
Director of Operations
Phone
(941) 964-2276

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

280 Park Avenue
Boca Grande, FL 33921

Mailing address

PO Box 517
Boca Grande, FL 33921-0517
Phone (941) 964-2276

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080708000383 FL Part B Supplier - Clinic/Group Practice 7810069879 Receives reassigned benefits from 2 practitioners
Practice locations: Boca Grande, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0294019Boca Grande Health Clinic280 Park Ave, Boca Grande, FL 33921Certificate of waiverMay 17, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778112000000",
    "number": "1972683910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 517",
            "city": "BOCA GRANDE",
            "state": "FL",
            "postal_code": "339210517",
            "telephone_number": "941-964-2276",
            "fax_number": "941-964-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 PARK AVENUE",
            "city": "BOCA GRANDE",
            "state": "FL",
            "postal_code": "33921",
            "telephone_number": "941-964-2276",
            "fax_number": "941-964-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOCA GRANDE HEALTH CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A",
        "authorized_official_last_name": "FOOS",
        "authorized_official_first_name": "JONNA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "941-964-2276"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Grande, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.