Mayo Clinic

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

PA 3550 Issued in FL

Legal business name

MAYO CLINIC

Practice address

4500 San Pablo Rd S
Jacksonville, FL 32224-1865

Phone

(904) 953-7330

NPI assigned

Apr 16, 2015

Last updated

Apr 16, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David ThielNPI 1326022294

Title

Department Chair

Phone

(904) 953-7330

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Thiel, MD

  • Urology Physician
  • Jacksonville, FL
  • NPI 1326022294
  Authorized official Same address or phone

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429142400000",
    "number": "1023405065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32224",
            "telephone_number": "904-953-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SAN PABLO RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322241865",
            "telephone_number": "904-953-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYO CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-16",
        "last_updated": "2015-04-16",
        "status": "A",
        "authorized_official_last_name": "THIEL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DEPARTMENT CHAIR",
        "authorized_official_telephone_number": "904-953-7330",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "PA 3550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eirc Maynard
• Jennifer Maynard, MD
• Latanya Renee Maynard, MA
• Alyssa Grace Maynor, M.ED. CF-SLP
• Jennifer Maynor, FNP-C
• Mayo Clinic Florida (Mayo Clinic Outpatient Dialysis Center)
• Mayo Clinic Florida
• Mayo Clinic Jacksonville (Mayo Clinic Home Infusion Pharmacy)
• Mayo Clinic Jacksonville (Mayo Clinic Jacksonville advanced care at home)
• Mayo Clinic Jacksonville (Mayo Clinic Jacksonville Medical Transport)

• Medical Specialty Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Medical Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.