Active NPI
Justin Craig Kusher, D.O.
- Pediatrics Physician
- Jacksonville, FL
National Provider Identifier
1083932693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- UO 2346
- Practice address
- 820 Prudential Dr
Howard BLDG, Suite 614
Jacksonville, FL 32207-8210 - Phone
- (904) 202-4212
- Fax
- (904) 202-4219
- NPI assigned
- May 6, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | UO 2346 | FL | Primary |
Addresses
Primary practice location
820 Prudential Dr
Howard BLDG, Suite 614
Jacksonville, FL 32207-8210
Mailing address
820 Prudential Dr
Howard BLDG, Suite 614
Jacksonville, FL 32207-8210
Phone (904) 202-4212
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UO 2346 | FL | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273104000000",
"number": "1083932693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 PRUDENTIAL DR",
"address_2": "HOWARD BLDG, SUITE 614",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078210",
"telephone_number": "904-202-4212",
"fax_number": "904-202-4219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 PRUDENTIAL DR",
"address_2": "HOWARD BLDG, SUITE 614",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078210",
"telephone_number": "904-202-4212",
"fax_number": "904-202-4219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUSHER",
"first_name": "JUSTIN",
"middle_name": "CRAIG",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-05-06",
"last_updated": "2010-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "UO 2346",
"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 May 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.