NPIMap

Organization Active NPI

Guidewell, Inc.

  • Early Intervention Provider Agency
  • Jacksonville, FL
National Provider Identifier
1043789662
Registry record updated Nov 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
GUIDEWELL, INC.
Practice address
4855 Town Center Pkwy
Jacksonville, FL 32246-8437
Phone
(904) 905-8618
NPI assigned
Nov 14, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2018

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

Authorized official

Name
Mr. Norman David Carter Jr.
Title
Diabetes Prevention Program Manager
Phone
(800) 477-3736

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

4855 Town Center Pkwy
Jacksonville, FL 32246-8437

Mailing address

4800 Deerwood Campus Pkwy
Jacksonville, FL 32246-6498
Phone (904) 905-8618

Other names 1

  • GuideWell Connect Doing business as

National Provider Directory

National Provider Directory

Locations

4855 Town Center Pkwy
Jacksonville, FL 32246
Phone (904) 363-5880

Practitioners & affiliated clinicians

Practitioners 10

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": "1542153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542153600000",
    "number": "1043789662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 DEERWOOD CAMPUS PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322466498",
            "telephone_number": "904-905-8618",
            "fax_number": "904-997-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 TOWN CENTER PKWY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322468437",
            "telephone_number": "904-905-8618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUIDEWELL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-14",
        "last_updated": "2018-11-14",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "DIABETES PREVENTION PROGRAM MANAGER",
        "authorized_official_telephone_number": "800-477-3736",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GuideWell Connect",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2018; 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.