Jean T. Proulx

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Practice address

3132 Beach Boulevard
Jacksonville, FL 32207-3710

Phone

(904) 398-7118

NPI assigned

Apr 25, 2012

Last updated

Apr 25, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1053679365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3132 BEACH BOULEVARD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073710",
            "telephone_number": "904-398-7118",
            "fax_number": "904-398-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 BEACH BOULEVARD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322073710",
            "telephone_number": "904-398-7118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROULX",
        "first_name": "JEAN",
        "middle_name": "T.",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Prosthetic/Orthotic Supplier in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.