SHORELINE MEDICAL GROUP, P.A. (NPI# 1427160571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1427160571 |
Entity Type | Organization |
Organization Name | SHORELINE MEDICAL GROUP, P.A. |
Practice Address |
419 Baltzell Ave Port St Joe FL 32456 |
Mailing Address |
419 Baltzell Ave Port St Joe FL 32456-1864 |
Practice Telephone | 8502298010 |
Practice Fax Number | 8502273177 |
Mailing Telephone | 8502298010 |
Mailing Fax Number | 8502273177 |
Enumeration Date | 2006-08-31 |
Last Update Date | 2018-12-19 |
Authorized Official Name | DR. THOMAS L CURRY (PRESIDENT) |
Authorized Official Telephone | 8502298010 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities | ||
Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 377827400 | 05 | |
FL | MEDICAID RHC | 377827401 | 01 |
MEDICARE RHC | 10-3887 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
419 Baltzell Ave, Port St Joe, FL 32456 | 8502298010 | 8502273177 |
Street Address |
419 BALTZELL AVE |
City | PORT ST JOE |
State | FL |
Zip Code | 32456 |
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 |
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 |
1790310845 | Alicja M Karnas | Counselor | 212 W. Highway 98, Suite C Town Centre Plaza, Port St. Joe, FL 32456 | 2020-03-10 |
Find all providers in zip 32456 |
Taxonomy Code | 207RN0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Nephrology |
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
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1285282871 | Lighthouse Renal Group Pa | Internal Medicine | 951 Nw 13th St Ste 5b, Boca Raton, FL 33486-2337 | 2019-08-28 |
1427617265 | Sunstate Kidney & Hypertension LLC | Internal Medicine | 9907 Warm Stone St, Thonotosassa, FL 33592-3350 | 2019-06-06 |
1205490091 | Central Florida Nephrology Pllc | Internal Medicine | 7350 Futures Dr Ste 1, Orlando, FL 32819-9082 | 2019-04-26 |
Find all providers with the same taxonomy |
City | PORT ST JOE |
Zip Code | 32456 |
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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.