Ayumi E Belanger, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA 9104224 Issued in FL

Practice address

91 Branscomb Rd
Suite 3
Green Cove Springs, FL 32043-7223

Phone

(904) 861-1034

Fax

(904) 861-1037

NPI assigned

Sep 12, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• FHIR API: https://epicproxy.et1206.epichosted.com/FHIRProxy/BHJ/api/FHIR/R4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497830400000",
    "number": "1003001058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1978",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320501978",
            "telephone_number": "904-282-6331",
            "fax_number": "904-282-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 BRANSCOMB RD",
            "address_2": "SUITE 3",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320437223",
            "telephone_number": "904-861-1034",
            "fax_number": "904-861-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELANGER",
        "first_name": "AYUMI",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2017-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA 9104224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292842600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Steven Raymond Bateh, DMD
• Venkata Bellamkonda, B.PHARMACY, M.S
• Paul Matthew Bertolino, LCSW
• Kelley Marie Biondolillo, RD LD
• Birth and Beyond
• Latisha Michelle Blanchard, PMHNP

• Medical Physician Assistant in Green Cove Springs, FL
• Providers in Green Cove Springs, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.