Gulf Coast Hma Physician Management LLC
NPI 1104498286ActiveOrganization· Psychiatry & Neurology, Neurology· Venice, FL
Psychiatry & Neurology, Neurology in Venice, Florida, registered in NPPES in July 2021. The authorized official on file is Jennifer L. Jackson, Sr Dir Prov Enrollment & Onboarding.
Overview
| NPI | 1104498286 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 16, 2021 |
| Last updated in NPPES | Mar 14, 2022 |
| Certified by provider | Mar 14, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychiatry & Neurology, Neurology Primary | 2084N0400X | — | — |
| Transplant Surgery | 204F00000X | — | — |
| Internal Medicine, Gastroenterology | 207RG0100X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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