Individual provider Active NPI

Andrew Steadman

  • Dentist
  • Jacksonville, FL
National Provider Identifier
1063935518
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7399 Issued in NE
Practice address
554 Keily Street
Jacksonville, FL 32212
Phone
(757) 953-7550
Fax
(757) 953-7560
NPI assigned
Jul 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7399 NE Primary

Addresses

Primary practice location

554 Keily Street
Jacksonville, FL 32212

Mailing address

554 Keily Street
Jacksonville, FL 32212
Phone (757) 953-7550

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

NPI Registry JSON

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063935518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 KEILY STREET",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32212",
            "telephone_number": "757-953-7550",
            "fax_number": "757-953-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 KEILY STREET",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32212",
            "telephone_number": "757-953-7550",
            "fax_number": "757-953-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEADMAN",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 21, 2022; 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.