East Volusia Family Practice PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

EAST VOLUSIA FAMILY PRACTICE PA

Practice address

3911 S Nova Rd
Port Orange, FL 32127-4910

Phone

(386) 322-0811

Fax

(386) 761-5449

NPI assigned

Feb 13, 2006

Last updated

Jul 9, 2008By 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. Lane E Jennings, M.D.

Title

President

Phone

(386) 322-0811

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215561600000",
    "number": "1053384610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3911 S NOVA RD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274910",
            "telephone_number": "386-322-0811",
            "fax_number": "386-761-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3911 S NOVA RD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274910",
            "telephone_number": "386-322-0811",
            "fax_number": "386-761-5449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VOLUSIA FAMILY PRACTICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-13",
        "last_updated": "2008-07-09",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "LANE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-322-0811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CH4732",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Central Florida Outpatient Imaging LLC (Radiology Associates Belvedere)
• East Central Florida Outpatient Imaging LLC (Port Orange Imaging Center)
• East Central Florida Outpatient Imaging LLC (Radiology Associates Port Orange West)
• East Coast Behavioral Services
• East Coast Chiropractic
• Srikanth Eathiraju
• Frank Lorenza Eberheart Jr.
• Eccentia Care
• Juan Pablo Echavarria
• Sarah Joyce Eckard, MSW

• Family Medicine Physician in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.