Active NPI
Marylin Palackel James, D.O
- Family Medicine Physician
- Jacksonville Beach, FL
National Provider Identifier
1023467347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- OS15761
- Practice address
- 3000 3Rd St South Suite 3004 B
Jacksonville Beach, FL 32250-5266 - Phone
- (904) 902-0150
- NPI assigned
- Jun 7, 2016
- 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 | OS15761 | FL | Primary |
Addresses
Primary practice location
3000 3Rd St South Suite 3004 B
Jacksonville Beach, FL 32250-5266
Mailing address
450 State Rd 13 North
Suite 106 PMB 157
St. Johns, FL 32259
Phone (904) 902-0150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2022 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS15761 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641686400000",
"number": "1023467347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 STATE RD 13 NORTH",
"address_2": "SUITE 106 PMB 157",
"city": "ST. JOHNS",
"state": "FL",
"postal_code": "32259",
"telephone_number": "904-902-0150",
"fax_number": "904-902-7172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 3RD ST SOUTH SUITE 3004 B",
"city": "JACKSONVILLE BEACH",
"state": "FL",
"postal_code": "322505266",
"telephone_number": "904-902-0150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMES",
"first_name": "MARYLIN",
"middle_name": "PALACKEL",
"credential": "D.O",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-07",
"last_updated": "2022-01-09",
"certification_date": "2022-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "OS15761",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2022; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.