Individual provider Active NPI

David Jourdenais, DVM

  • Veterinarian
  • Geneva, FL
National Provider Identifier
1053717249
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
VM5281 Issued in FL
Practice address
4193 N County Road 426
Geneva, FL 32732-9035
Phone
(407) 349-9536
NPI assigned
Nov 14, 2014
Last updated
Nov 14, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X VM5281 FL Primary

Addresses

Primary practice location

4193 N County Road 426
Geneva, FL 32732-9035

Mailing address

4193 N County Road 426
Geneva, FL 32732-9035
Phone (407) 349-9536

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
VM5281FLMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1053717249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4193 N COUNTY ROAD 426",
            "city": "GENEVA",
            "state": "FL",
            "postal_code": "327329035",
            "telephone_number": "407-349-9536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4193 N COUNTY ROAD 426",
            "city": "GENEVA",
            "state": "FL",
            "postal_code": "327329035",
            "telephone_number": "407-349-9536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOURDENAIS",
        "first_name": "DAVID",
        "credential": "DVM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-14",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "FL",
            "license": "VM5281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; 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.