Organization Active NPI

Dennis D. Dewey, M.D., P.a.

  • Neurology Physician
  • Orange Park, FL
National Provider Identifier
1073840435
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME47968 Issued in FL
Legal business name
DENNIS D. DEWEY, M.D., P.A.
Practice address
1895 Kingsley Ave Ste 805
Orange Park, FL 32073-4410
Phone
(904) 276-2220
Fax
(904) 276-2578
NPI assigned
Nov 5, 2009
Last updated
Jan 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Authorized official

Name
Dennis D Dewey, MD
Title
President
Phone
(904) 276-2220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X ME47968 FL Primary

Addresses

Primary practice location

1895 Kingsley Ave Ste 805
Orange Park, FL 32073-4410

Mailing address

PO Box 17809
Jacksonville, FL 32245-7809
Phone (904) 723-5665

Other identifiers 2

IdentifierTypeStateIssuer
14167OtherFLBCBS
DP9414OtherFLR.R. MEDICARE

National Provider Directory

National Provider Directory

Locations

1895 Kingsley Ave
Ste 805
Orange Park, FL 32073
Phone (904) 276-2220

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294272000000",
    "number": "1073840435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17809",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322457809",
            "telephone_number": "904-723-5665",
            "fax_number": "904-338-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 KINGSLEY AVE STE 805",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734410",
            "telephone_number": "904-276-2220",
            "fax_number": "904-276-2578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS D. DEWEY, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-05",
        "last_updated": "2011-01-06",
        "status": "A",
        "authorized_official_last_name": "DEWEY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-276-2220",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME47968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14167",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.R. MEDICARE",
            "identifier": "DP9414",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; 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.