Port Charlotte Hma Physician Management LLC
NPI 1659039311ActiveOrganization· Surgery, Vascular Surgery· Port Charlotte, FL
Surgery, Vascular Surgery in Port Charlotte, Florida, registered in NPPES in November 2021. The authorized official on file is Jennifer L. Jackson, Sr Dir Prov Enrollment & Onboarding.
Overview
| NPI | 1659039311 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 30, 2021 |
| Last updated in NPPES | May 25, 2022 |
| Certified by provider | May 25, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery, Vascular Surgery Primary | 2086S0129X | — | — |
| Internal Medicine, Gastroenterology | 207RG0100X | — | — |
| Nurse Practitioner, Acute Care | 363LA2100X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 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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