NPIMap

Organization Active NPI

Psychiatric Associates, PA

  • Psychiatry Physician
  • Orange Park, FL
National Provider Identifier
1023039161
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PSYCHIATRIC ASSOCIATES, PA
Practice address
1543 Kingsley Ave
BLDG 14
Orange Park, FL 32073-4535
Phone
(904) 264-6977
Fax
(904) 269-0870
NPI assigned
Jul 22, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
James Lionel Larson, MD
Title
President
Phone
(904) 264-6977

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X NU Primary

Addresses

Primary practice location

1543 Kingsley Ave
BLDG 14
Orange Park, FL 32073-4535

Mailing address

1543 Kingsley Ave
BLDG 14
Orange Park, FL 32073-4535
Phone (904) 264-6977

Other names 1

  • GENOVA AND ASSOCIATES Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023039161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 KINGSLEY AVE",
            "address_2": "BLDG 14",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734535",
            "telephone_number": "904-264-6977",
            "fax_number": "904-269-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 KINGSLEY AVE",
            "address_2": "BLDG 14",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734535",
            "telephone_number": "904-264-6977",
            "fax_number": "904-269-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRIC ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "LIONEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-264-6977",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GENOVA AND ASSOCIATES",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.