Active NPI
Marcia Wayne Funderburk, M.D.
- Family Medicine Physician
- Jacksonville, FL
National Provider Identifier
1003875345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME51523
- Practice address
- 1255 Lila St
Ufjp Lem Turner Family Practice Center
Jacksonville, FL 32208-3550 - Phone
- (904) 244-5802
- Fax
- (904) 244-5791
- NPI assigned
- Mar 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME51523 | FL | Primary |
Addresses
Primary practice location
1255 Lila St
Ufjp Lem Turner Family Practice Center
Jacksonville, FL 32208-3550
Mailing address
PO Box 44008
Ufjp Provider Enrollment
Jacksonville, FL 32231-4008
Phone (904) 244-3660
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Iowa, RJ & L Carver College of Medicine, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
450077 State Rd
Suite 12
Callahan, FL 32011-3863
Phone (904) 633-0560
Merit-based Incentive Payment System (MIPS)
- Final score
- 59.59 of 100
- Quality
- 59.93
- Promoting interoperability
- 0
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME51523 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Florida Jacksonville Physicians, Inc. | Family Medicine | Current | Accepting new patients |
| University of Florida Jacksonville Physicians Inc | Current | Accepting new patients | |
| University of Florida Jacksonville Physicians, Inc. | Family Medicine | Past | Accepting new patients |
Locations
655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680
1255 Lila St
Jacksonville, FL 32208
Phone (904) 244-5700
Interoperability endpoints
- mfunderburk59328@direct.shands.ufl.edu
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196553600000",
"number": "1003875345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 44008",
"address_2": "UFJP PROVIDER ENROLLMENT",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322314008",
"telephone_number": "904-244-3660",
"fax_number": "904-244-3425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1255 LILA ST",
"address_2": "UFJP LEM TURNER FAMILY PRACTICE CENTER",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322083550",
"telephone_number": "904-244-5802",
"fax_number": "904-244-5791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUNDERBURK",
"first_name": "MARCIA",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-23",
"last_updated": "2007-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME51523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.