NPIMap

Organization Active NPI

Ackerman Cancer Center

Doing business as Ackerman Urology

  • Urology Physician
  • Orange Park, FL
National Provider Identifier
1093174377
Registry record updated Jul 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
ME92864 Issued in FL
Legal business name
ACKERMAN CANCER CENTER
Doing business as
Ackerman Urology
Practice address
1895 Kingsley Ave
Suite 903
Orange Park, FL 32073-4466
Phone
(904) 644-8353
Fax
(904) 644-8289
NPI assigned
Feb 16, 2016
Last updated
Jul 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2023

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

Authorized official

Name
Scot Ackerman, MDNPI 1942205364
Title
Authorized Official
Phone
(904) 880-5522

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
Urology Physician 208800000X ME92864 FL Primary

Addresses

Primary practice location

1895 Kingsley Ave
Suite 903
Orange Park, FL 32073-4466

Mailing address

10881 San Jose Blvd
Jacksonville, FL 32223-6612
Phone (904) 260-3022

Other names 1

  • Ackerman Urology Doing business as

National Provider Directory

National Provider Directory
Tax ID family
First Coast Oncology GR10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1455580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689206400000",
    "number": "1093174377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10881 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236612",
            "telephone_number": "904-260-3022",
            "fax_number": "904-260-3947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 KINGSLEY AVE",
            "address_2": "SUITE 903",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734466",
            "telephone_number": "904-644-8353",
            "fax_number": "904-644-8289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACKERMAN CANCER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-16",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A",
        "authorized_official_last_name": "ACKERMAN",
        "authorized_official_first_name": "SCOT",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "904-880-5522",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "ME92864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ackerman Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 13, 2023; 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.