Organization Active NPI

First Coast Allergy and Asthma PA

  • Allergy & Immunology Physician
  • Jacksonville, FL
National Provider Identifier
1083668511
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
ME87944 Issued in FL
Legal business name
FIRST COAST ALLERGY AND ASTHMA PA
Practice address
9191 R.G. Skinner Parkway
Suite 402
Jacksonville, FL 32256-9179
Phone
(904) 642-9001
Fax
(904) 642-9150
NPI assigned
May 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sanjay Swami, M.D.NPI 1578517009
Title
Owner
Phone
(904) 642-9001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X ME87944 FL Primary

Addresses

Primary practice location

9191 R.G. Skinner Parkway
Suite 402
Jacksonville, FL 32256-9179

Mailing address

9838 Old Baymeadows Rd
PMB #358
Jacksonville, FL 32256-8101
Phone (904) 642-9001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051010000266 FL Part B Supplier - Clinic/Group Practice 7911922927 Receives reassigned benefits from 2 practitioners
Practice locations: Jacksonville, FL; Ponte Vedra, FL; Fernandina Beach, FL

National Provider Directory

National Provider Directory

Locations

9838 Old Baymeadows Rd
Jacksonville, FL 32256
Phone (904) 472-0537

9191 R G Skinner Pkwy
#430
Jacksonville, FL 32256

9191 R G Skinner Pkwy
Unit 402
Jacksonville, FL 32256
Phone (904) 642-9001

486 Town Plaza Ave
Ste 430
Ponte Vedra, FL 32081
Phone (904) 642-9001

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083668511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9838 OLD BAYMEADOWS RD",
            "address_2": "PMB #358",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322568101",
            "telephone_number": "904-642-9001",
            "fax_number": "904-642-9150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9191 R.G. SKINNER PARKWAY",
            "address_2": "SUITE 402",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322569179",
            "telephone_number": "904-642-9001",
            "fax_number": "904-642-9150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST ALLERGY AND ASTHMA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SWAMI",
        "authorized_official_first_name": "SANJAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-642-9001",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "FL",
            "license": "ME87944",
            "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.