Organization Active NPI

Neurotek Inc

  • Neurology Physician
  • Orange Park, FL
National Provider Identifier
1033534821
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME59449 Issued in FL
Legal business name
NEUROTEK INC
Practice address
1202 Kingsley Ave
Orange Park, FL 32073-4632
Phone
(904) 281-1066
NPI assigned
Mar 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Authorized official

Name
Lawrence S Guthrie
Title
President
Phone
(904) 281-1066

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X ME59449 FL Primary

Addresses

Primary practice location

1202 Kingsley Ave
Orange Park, FL 32073-4632

Mailing address

PO Box 17809
Jacksonville, FL 32245-7809
Phone (904) 723-5665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140627000479 FL Part B Supplier - Clinic/Group Practice 1658596085 Receives reassigned benefits from 1 practitioner
Practice locations: Orange Park, FL

National Provider Directory

National Provider Directory

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": "1393804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1033534821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17809",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322457809",
            "telephone_number": "904-723-5665",
            "fax_number": "904-338-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734632",
            "telephone_number": "904-281-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROTEK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-03",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "GUTHRIE",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-281-1066"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME59449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.