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SANTA ROSA MEDICAL GROUP CARDIOLOGY
NPI 1518636927
Internal Medicine - Cardiovascular Disease in Milton, FL

Active since September 09, 2021CLIA Certified · 4 labs
5992 BERRYHILL RD STE 201, MILTON, FL 32570(850) 981-3885(850) 626-5474 Get Directions Write a Review

NPPES record last updated: March 16, 2022. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Santa Rosa Medical Group Cardiology NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANTA ROSA MEDICAL GROUP CARDIOLOGY (NPI 1518636927) is a healthcare organization registered as a cardiovascular disease in Milton, Florida and active in the NPI registry since September 2021. The organization holds 4 active CLIA laboratory certificates and lists Jennifer L Jackson, Sr Dr Prov Enrollment & Onboarding, as its authorized official.

NPPES Registry Identity

NPI1518636927
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameSANTA ROSA HMA PHYSICIAN MANAGEMENT LLC
Location Address5992 BERRYHILL RD STE 201Milton, FL 32570-1014
Mailing AddressPo Box 689022Franklin, TN 37068-9022 · (615) 465-7211 · Fax (615) 628-6877
Phone(850) 981-3885
Fax(850) 626-5474
Organization SubpartNo
Authorized OfficialJennifer L JacksonSr Dr Prov Enrollment & Onboarding · (615) 465-3334
Enumeration DateSeptember 9, 2021
Last NPPES UpdateMarch 16, 2022
NPPES CertifiedMarch 16, 2022
✔ NPI 1518636927 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedUrologyTaxonomy 208800000X
5992 BERRYHILL RD STE 201, Milton, FL 32570
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Other Names 1

Doing Business AsSanta Rosa Medical Group Cardiology

Other Identifiers 1

MedicaidPENDINGFL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 4

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1087232

Santa Rosa Medical Group · Milton, FL
Active · expires May 1, 2028
CLIA Number10D1087232
Laboratory TypePhysician Office
Certificate Effective DateMay 2, 2026
Certificate Expiration DateMay 1, 2028
Laboratory DirectorGenevieve Hinks
Laboratory Phone(850) 626-5070
Laboratory LocationSanta Rosa Medical Group6072 Doctors Park Rd, Milton, FL 32570
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2234236

Santa Rosa Medical Group · Milton, FL
Active · expires Aug 29, 2027
CLIA Number10D2234236
Laboratory TypePhysician Office
Certificate Effective DateAugust 30, 2025
Certificate Expiration DateAugust 29, 2027
Laboratory DirectorAndrew Horowitz
Laboratory Phone(850) 981-7742
Laboratory LocationSanta Rosa Medical Group5992 Berryhill Road Suite 102, Milton, FL 32570
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2316713

Santa Rosa Medical Group · Milton, FL
Active · expires Jan 9, 2027
CLIA Number10D2316713
Laboratory TypePhysician Office
Certificate Effective DateJanuary 10, 2025
Certificate Expiration DateJanuary 9, 2027
Laboratory DirectorWilliam Bickers
Laboratory Phone(850) 626-5389
Laboratory LocationSanta Rosa Medical Group5992 Berryhill Rd Ste 205, Milton, FL 32570
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2312821

Santa Rosa Medical Group · Milton, FL
Active · expires Oct 17, 2026
CLIA Number10D2312821
Laboratory TypePhysician Office
Certificate Effective DateOctober 18, 2024
Certificate Expiration DateOctober 17, 2026
Laboratory DirectorRicardo K. Mohammed
Laboratory Phone(850) 626-5121
Laboratory LocationSanta Rosa Medical Group5992 Berryhill Rd Suite #203, Milton, FL 32570
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALYSSA SHEEDLO RD
Dietitian, Registered
5992 BERRYHILL RD STE 201
MILTON, FL 32570
Santa Rosa County (850) 626-5125

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Santa Rosa Hma Physician Management LLC's NPI number?

The NPI number for Santa Rosa Hma Physician Management LLC is 1518636927. It was assigned to this organization in the NPPES registry on September 9, 2021. The provider is doing business as Santa Rosa Medical Group Cardiology.

Where is Santa Rosa Hma Physician Management LLC located?

Santa Rosa Hma Physician Management LLC is located at 5992 Berryhill Rd Ste 201, Milton, FL 32570. The listed phone number is (850) 981-3885.

What is Santa Rosa Hma Physician Management LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Does Santa Rosa Hma Physician Management LLC hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Santa Rosa Hma Physician Management LLC was last updated on March 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.