Individual provider Active NPI

Michael John Parsons, MD

  • Family Medicine Physician
  • Palm Coast, FL
National Provider Identifier
1033169669
Registry record updated Dec 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19645 Issued in WV
Practice address
309 Palm Coast Pkwy NE
Palm Coast, FL 32137-3886
Phone
(386) 445-7073
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19645 WV Primary

Addresses

Primary practice location

309 Palm Coast Pkwy NE
Palm Coast, FL 32137-3886

Mailing address

799 Terry LN
Clarksburg, WV 26301-6677
Phone (304) 698-5113

Other practice location 1

411 Walnut St # 14389
Green Cove Springs, FL 32043-3443
Phone (304) 329-0555

Other identifiers 1

IdentifierTypeStateIssuer
1804868000MedicaidWV

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190104001755 FL Practitioner - Family Practice 5597751362 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19645WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Health Care Plan, Inc CurrentSince Dec 10, 2018 Accepting new patients
Florida Health Care Plan, Inc CurrentSince Dec 10, 2018 Accepting new patients

Locations

309 Palm Coast Pkwy NE
Palm Coast, FL 32137
Phone (386) 445-7073

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609372800000",
    "number": "1033169669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 TERRY LN",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263016677",
            "telephone_number": "304-698-5113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 PALM COAST PKWY NE",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373886",
            "telephone_number": "386-445-7073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 Walnut St # 14389",
            "address_purpose": "LOCATION",
            "city": "Green Cove Springs",
            "state": "FL",
            "postal_code": "320433443",
            "country_code": "US",
            "telephone_number": "304-329-0555",
            "fax_number": "304-329-0556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARSONS",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2020-12-31",
        "certification_date": "2020-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "19645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1804868000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

Verify at the official NPI Registry.