SACRED HEART HOSPITAL ON THE GULF (NPI# 1912495375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912495375 |
| Entity Type | Organization |
| Organization Name | SACRED HEART HOSPITAL ON THE GULF |
| Other Organization Name | SACRED HEART MEDICAL GROUP ON THE GULF RURAL HEALTH AT PSJ |
| Practice Address |
3871 E Highway 98 Ste 203 Port St Joe FL 32456-5302 |
| Mailing Address |
Po Box 2699 Attn: Shmg/hpe Pensacola FL 32513-2699 |
| Practice Telephone | 8502295661 |
| Practice Fax Number | 8502295662 |
| Mailing Telephone | 8502295661 |
| Mailing Fax Number | 8502295662 |
| Enumeration Date | 2018-05-01 |
| Last Update Date | 2018-05-01 |
| Authorized Official Name | RONDA MICHELLE BOND (TRANSFORMATION SPECIALIST) |
| Authorized Official Telephone | 8504754682 |
| Authorized Official Credential | CMA, CPC |
| Is Organization Subpart | Y |
| Parent Organization Name | SACRED HEART HEALTH SYSTEM, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Sacred Heart Medical Group on the Gulf Rural Health at PSJ | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023506532 | Sacred Heart Hospital On The Gulf | Clinic/Center | 805 Highway 22, Wewahitchka, FL 32465-3237 | 2018-04-30 |
| 1982963344 | Sacred Heart Hospital On The Gulf | Clinic/Center | 55 Avenue 'e', Apalachicola, FL 32320-1763 | 2012-05-04 |
| 1912466194 | Sacred Heart Hospital On The Gulf | Clinic/Center | 3871 E Highway 98 Ste 201, Port St Joe, FL 32456-5302 | 2019-03-18 |
| 1528336302 | Sacred Heart Hospital On The Gulf | Internal Medicine | 4451 Bayou Blvd, Attn: Shmg/hpe, Pensacola, FL 32503-2601 | 2011-12-07 |
| 1083941678 | Sacred Heart Hospital On The Gulf | Medicare Defined Swing Bed Unit | 3801 E Highway 98, Port St Joe, FL 32456-5318 | 2009-11-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SACRED HEART HOSPITAL ON THE GULF | 3801 E Highway 98, Port Saint Joe, FL 32456-5318 |
| Street Address |
3871 E HIGHWAY 98 STE 203 |
| City | PORT ST JOE |
| State | FL |
| Zip Code | 32456-5302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457853038 | Richard Petch | Nurse Practitioner | 3871 E Highway 98 Ste 203, Port St Joe, FL 32456-5302 | 2018-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609379825 | Melanie Q Larry | Case Manager/Care Coordinator | 212 W. Highway 98, Suite C Town Center Plaza, Port St. Joe, FL 32456 | 2018-03-14 |
| 1972029833 | Tem Medical | Internal Medicine | 220 9th Street, Port St Joe, FL 32456 | 2017-08-22 |
| 1770018731 | Gulf County Association for Retarded Citizens, Inc. | Non-emergency Medical Transport (VAN) | 122 Water Plant Road, Port St Joe, FL 32456 | 2017-04-27 |
| 1477815488 | Patricia J Mitchell | Nurse Practitioner | 256 Canal Street, Port Saint Joe, FL 32456 | 2012-06-14 |
| 1407135296 | Chrystal R Cox | Occupational Therapist | 6801 Us Highway 98, Port St. Joe, FL 32456 | 2011-08-10 |
| 1467662957 | William Rex Buzzett | Pharmacist | 302 Cecil G Costin Blvd, Port St Joe, FL 32456 | 2007-05-23 |
| 1831293802 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 110 Hwy 98, Port Saint Joe, FL 32456 | 2006-09-12 |
| 1427160571 | Shoreline Medical Group, P.a. | Internal Medicine | 419 Baltzell Ave, Port St Joe, FL 32456 | 2006-08-31 |
| 1851403992 | Elizabeth F Curry | Pediatrics | 3871 E Highway 98 Ste 201, Port St Joe, FL 32456 | 2006-08-31 |
| 1891715702 | Champion Medical Equipment Rental &sales LLC | Durable Medical Equipment & Medical Supplies | 324 Long Ave Port St, Joe, FL 32456 | 2006-07-20 |
| Find all providers in zip 32456 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912466194 | Sacred Heart Hospital On The Gulf | Clinic/Center | 3871 E Highway 98 Ste 201, Port St Joe, FL 32456-5302 | 2019-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952917015 | Bonifay Rural Health Cinic | Clinic/Center | 2910 Hospital Dr Ste A, Bonifay, FL 32425-4268 | 2020-09-23 |
| 1013540947 | Clark Clinic Inc | Clinic/Center | 12620 Curley St, San Antonio, FL 33576-8136 | 2020-02-19 |
| 1023506532 | Sacred Heart Hospital On The Gulf | Clinic/Center | 805 Highway 22, Wewahitchka, FL 32465-3237 | 2018-04-30 |
| 1639693492 | Clark Clinic Inc | Clinic/Center | 910 W Myers Blvd, Mascotte, FL 34753-9748 | 2017-08-02 |
| 1194173419 | Holmes County Hospital Corporation | Clinic/Center | 5556 Brown St, Graceville, FL 32440-1007 | 2016-05-26 |
| 1568826873 | Healthvine Medical Group Inc | Clinic/Center | 725 Benton Ave, Brooksville, FL 34601-3213 | 2016-04-12 |
| 1164808465 | Family and After Hours Care, LLC | Clinic/Center | 1413 Nw 23rd Ave, Chiefland, FL 32626 | 2015-08-10 |
| 1891171914 | High Springs Pediatrics LLC. | Clinic/Center | 14900 Nw 140th St, Alachua, FL 32615-6276 | 2015-07-31 |
| 1982963344 | Sacred Heart Hospital On The Gulf | Clinic/Center | 55 Avenue 'e', Apalachicola, FL 32320-1763 | 2012-05-04 |
| 1760776900 | Sonnis Pediatrics, Inc. | Clinic/Center | 1125 S 6th Ave, Wauchula, FL 33873-3350 | 2011-06-06 |
| Find all providers with the same taxonomy | ||||
| City | PORT ST JOE |
| Zip Code | 32456 |
Please comment or provide details below to improve the information on SACRED HEART HOSPITAL ON THE GULF.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.