LIVE OAK HMA, LLC (NPI# 1255430757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255430757 |
| Entity Type | Organization |
| Organization Name | LIVE OAK HMA, LLC |
| Other Organization Name | SHANDS LIVE OAK REGIONAL MEDICAL CENTER |
| Practice Address |
1100 11th St Sw Live Oak FL 32064-3608 |
| Practice Telephone | 3863620800 |
| Practice Fax Number | 3527330069 |
| Mailing Telephone | 3863620800 |
| Mailing Fax Number | 3527330069 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2018-02-22 |
| Authorized Official Name | PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL) |
| Authorized Official Telephone | 6159254565 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
4314 | FL | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 010179600 | 05 | |
| FL | MEDICARE RAIL ROAD | CF9177 | 01 |
| Other Name | Type Code |
|---|---|
| Shands Live Oak Regional Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720591613 | Live Oak Hma, LLC | Medicare Defined Swing Bed Unit | 1100 11th St Sw, Live Oak, FL 32064-3608 | 2017-11-14 |
| 1174921696 | Live Oak Hma, LLC | Family Medicine | 1426 Canyon Ave Ne, Unit B, Live Oak, FL 32064-4832 | 2014-12-16 |
| 1669568499 | Live Oak Hma, LLC | Clinic/Center | 1426 Canyon Ave Ne, Unit B, Live Oak, FL 32064-4832 | 2006-10-05 |
| Street Address |
1100 11TH ST SW |
| City | LIVE OAK |
| State | FL |
| Zip Code | 32064-3608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538186978 | Mahendra R. Sheth | Emergency Medicine | 1100 11th St Sw, Live Oak, FL 32064-3608 | 2006-07-15 |
| 1114574548 | Kristina Melissa North | Nurse Practitioner | 1100 11th St Sw, Live Oak, FL 32064-3608 | 2019-08-21 |
| 1245718295 | Ryan Hillman Reynolds | Nurse Practitioner | 1100 11th St Sw, Live Oak, FL 32064-3608 | 2018-08-01 |
| 1861900177 | Gabrielle Terry | Pharmacist | 1100 11th St Sw, Live Oak, FL 32064-3608 | 2018-01-21 |
| 1720591613 | Live Oak Hma, LLC | Medicare Defined Swing Bed Unit | 1100 11th St Sw, Live Oak, FL 32064-3608 | 2017-11-14 |
| 1669917472 | Suwannee Emergency Group LLC | Physician Assistant | 1100 11th St Sw, Live Oak, FL 32064-3608 | 2017-01-03 |
| 1720453970 | Melissa Dionne Daniels | Pharmacist | 1100 11th St Sw, Live Oak, FL 32064-3608 | 2015-12-13 |
| 1487051314 | Nico Dorfling Kristen | Emergency Medicine | 1100 11th St Sw, Live Oak, FL 32064-3608 | 2014-11-20 |
| 1093131096 | Frederick Sanders | Pharmacist | 1100 11th St Sw, Live Oak, FL 32064-3608 | 2014-03-14 |
| 1811233505 | Ascension Internal Medicine of Florida, LLC | Internal Medicine | 1100 11th St Sw, Live Oak, FL 32064-3608 | 2012-12-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912517988 | Publix Super Markets, Inc | Durable Medical Equipment & Medical Supplies | 2215 Ohio Ave N, Live Oak, FL 32064 | 2020-08-05 |
| 1821641150 | North Florida Natural Health, Inc | Clinic/Center | 405 11th Street Sw, Suite 206, Live Oak, FL 32064 | 2019-07-16 |
| 1558602482 | North Florida Pediatrics, Pa | Pediatrics | 1101 Ohio Ave South, Live Oak, FL 32064 | 2013-03-01 |
| 1427372093 | Steele Chiropractic Center, Inc | Chiropractor | 609 5th Street S.w., Suite 3, Live Oak, FL 32064 | 2010-03-25 |
| 1982855896 | John Workman, Dc, Pllc | Chiropractor | 216 Duval St Nw, Live Oak, FL 32064 | 2008-10-09 |
| 1629255799 | Alec Floyd Redfearn Jr. | Dentist | 931 North Ohio Avenue, Live Oak, FL 32064 | 2008-01-30 |
| 1639369051 | Julie L Owens Od Pa | Optometrist | 522 S. Ohio Ave, Live Oak, FL 32064 | 2007-08-01 |
| 1568512291 | Gina R Marler | Speech-Language Pathologist | 609 5th Street Sw Suite 3, Live Oak, FL 32064 | 2007-01-12 |
| 1174687230 | Suwannee County School Board | Local Education Agency (LEA) | 702 E Second St Nw, Live Oak, FL 32064 | 2006-12-21 |
| 1134235583 | Richard D Cason | Chiropractor | 328 West Howard Street, Live Oak, FL 32064 | 2006-08-21 |
| Find all providers in zip 32064 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952850828 | Tanya Kischa Bethel-hall | General Acute Care Hospital | 3094 Nw 72nd Ave, Margate, FL 33063-7878 | 2016-10-03 |
| 1033663752 | Uf Health | General Acute Care Hospital | 3529 Nw 42nd Ter, Gainesville, FL 32606-8131 | 2016-08-10 |
| 1902103583 | Lee Memorial | General Acute Care Hospital | 13681 Doctors Way Ste 16043, Fort Myers, FL 33912-4300 | 2011-02-17 |
| 1477871069 | Jackson Memorial Hospital | General Acute Care Hospital | 4304 E Whitewater Ave, Weston, FL 33332-2409 | 2010-05-07 |
| 1194953828 | Mount Sinai Medical Center | General Acute Care Hospital | 14700 Ne 9th Ave, Miami, FL 33161-2316 | 2009-07-01 |
| 1518157551 | Malcom Randall Va Medical Center | General Acute Care Hospital | 1601 S.w Archer Road, Gainesville, FL 32608-1135 | 2007-07-26 |
| 1720288921 | Joanne Lynn Brousseau | General Acute Care Hospital | 221 6th Ave S Apt E, Jacksonville, FL 32250-6664 | 2007-07-25 |
| 1306046131 | Jackson Hospital | General Acute Care Hospital | 10730 Sw 30th Pl, Davie, FL 33328-1536 | 2007-07-19 |
| 1649480146 | St Mary Surgical Inc | General Acute Care Hospital | 5343 59th Circle West, Kenneth City, FL 33709 | 2007-05-23 |
| 1477618387 | Department of Va, Miami Va Health Care | General Acute Care Hospital | 12530 Ne 1st, Miami, FL 33161 | 2006-12-22 |
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| 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.