NPI Code Detail JSON Logo

1215735808 NPI number — COMMUNITY HEALTH INITIATIVES GROUP, INC.

NPI Number: 1215735808
Health Care Provider/Practitioner: COMMUNITY HEALTH INITIATIVES GROUP, INC.

Information about “1215735808” NPI (COMMUNITY HEALTH INITIATIVES GROUP, INC.) exists in 1215735808 in HTML format HTML  |  1215735808 in plain Text format TXT  |  1215735808 in PDF (Portable Document Format) PDF  |  1215735808 in an XML format XML  formats.

NPI Number : 1215735808 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215735808",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "COMMUNITY HEALTH INITIATIVES GROUP, INC.",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "8411 SOUTHSIDE BLVD STE 100",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JACKSONVILLE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32256-0755",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "904-323-4488",
    "MailingAddressFaxNumber": "904-323-4488",
    "FirstLinePracticeLocationAddress": "934 ARLINGTON RD N",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JACKSONVILLE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32211-5956",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "904-323-4488",
    "PracticeLocationAddressFaxNumber": "904-323-4488",
    "EnumerationDate": "03/07/2025",
    "LastUpdateDate": "03/07/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MOUNT",
    "AuthorizedOfficialFirstName": "JASON",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "904-699-2332",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QC1500X",
          "TaxonomyName": "Community Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0801X",
          "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3336C0002X",
          "TaxonomyName": "Clinic Pharmacy",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QP2300X",
          "TaxonomyName": "Primary Care Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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