NPIMap

Organization Active NPI

Id Associates of Jacksonville PA

  • Infectious Disease Physician
  • Jacksonville, FL
National Provider Identifier
1013107077
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
Legal business name
ID ASSOCIATES OF JACKSONVILLE PA
Practice address
2 Shircliff Way
Ste 610
Jacksonville, FL 32204-4753
Phone
(904) 387-5027
Fax
(904) 387-2208
NPI assigned
Jul 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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

Authorized official

Name
Dr. Jean-Paul Montoya, MDNPI 1619081403
Title
Owner
Phone
(904) 387-5027

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X Primary

Addresses

Primary practice location

2 Shircliff Way
Ste 610
Jacksonville, FL 32204-4753

Mailing address

2 Shircliff Way
Ste 610
Jacksonville, FL 32204-4753
Phone (904) 387-5027

Other identifiers 1

IdentifierTypeStateIssuer
001362900MedicaidFL

National Provider Directory

National Provider Directory

Locations

2 Shircliff Way
Ste 610
Jacksonville, FL 32204
Phone (904) 387-5027

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309996800000",
    "number": "1013107077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY",
            "address_2": "STE 610",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044753",
            "telephone_number": "904-387-5027",
            "fax_number": "904-387-2208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY",
            "address_2": "STE 610",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044753",
            "telephone_number": "904-387-5027",
            "fax_number": "904-387-2208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ID ASSOCIATES OF JACKSONVILLE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2011-07-07",
        "status": "A",
        "authorized_official_last_name": "MONTOYA",
        "authorized_official_first_name": "JEAN-PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-387-5027",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001362900",
            "state": "FL"
        }
    ],
    "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 Jul 7, 2011; 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.