| Entity Name: | COLUMBIA OCALA REGIONAL MEDICAL CENTER PHYSICIAN GROUP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 17 Feb 1997 (28 years ago) |
| Document Number: | P97000015120 |
| FEI/EIN Number | 62-1678901 |
| Address: | ONE PARK PLAZA, NASHVILLE, TN 37203 |
| Mail Address: | P.O. BOX 750, NASHVILLE, TN 37202-0750 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932263621 | 2006-12-20 | 2009-02-10 | 700 SE 5TH TER, SUITE 5, CRYSTAL RIVER, FL, 344294878, US | 700 SE 5TH TER, SUITE 5, CRYSTAL RIVER, FL, 344294878, US | |||||||||||||||||||||
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| Phone | +1 352-795-8815 |
| Fax | 3525641090 |
Authorized person
| Name | JOHN JOHANNESSEN |
| Role | VP |
| Phone | 7277936004 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | P00646524 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 |
| Name | Role | Address |
|---|---|---|
| CUFFE, MICHAEL | Director | 2000 HealthPark Drive, BRENTWOOD, TN 37027 |
| WYATT, CHRISTOPHER F | Director | ONE PARK PLAZA, NASHVILLE, TN 37203 |
| Name | Role | Address |
|---|---|---|
| CUFFE, MICHAEL | President | 2000 HealthPark Drive, BRENTWOOD, TN 37027 |
| Name | Role | Address |
|---|---|---|
| WYATT, CHRISTOPHER F | Senior Vice President | ONE PARK PLAZA, NASHVILLE, TN 37203 |
| Hackett, John M. | Senior Vice President | One Park Plaza, Nashville, TN 37203 |
| Name | Role | Address |
|---|---|---|
| FRANCK , JOHN M, II | DVPA | ONE PARK PLAZA, NASHVILLE, TN 37203 |
| Name | Role | Address |
|---|---|---|
| Hackett, John M. | Treasurer | One Park Plaza, Nashville, TN 37203 |
| Name | Role | Address |
|---|---|---|
| Grubbs, Ronald L., Jr. | Vice President | ONE PARK PLAZA, NASHVILLE, TN 37203 |
| CLINE, NATALIE H | Vice President | ONE PARK PLAZA, NASHVILLE, TN 37203 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2004-04-22 | ONE PARK PLAZA, NASHVILLE, TN 37203 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2003-04-30 | ONE PARK PLAZA, NASHVILLE, TN 37203 | No data |
| REGISTERED AGENT NAME CHANGED | 2002-04-22 | CT CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2002-04-22 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-19 |
| ANNUAL REPORT | 2023-04-18 |
| ANNUAL REPORT | 2022-04-28 |
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-04-29 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-04-22 |
| ANNUAL REPORT | 2017-04-24 |
| ANNUAL REPORT | 2016-04-24 |
| ANNUAL REPORT | 2015-04-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
