Individual provider Active NPI

Lawrence Edward Hoening, P.A.

  • Medical Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1093731283
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9103141 Issued in FL
Practice address
5045 Soutel Dr Ste 12
Jacksonville, FL 32208-1885
Phone
(190) 446-8794
Fax
(904) 468-7944
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA91031 FL
Medical Physician Assistant 363AM0700X PA9103141 FL Primary

Addresses

Primary practice location

5045 Soutel Dr Ste 12
Jacksonville, FL 32208-1885

Mailing address

5045 Soutel Dr Ste 12
Jacksonville, FL 32208-1885
Phone (904) 446-8794

Other identifiers 1

IdentifierTypeStateIssuer
292818300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050824000136 FL Practitioner - Physician Assistant 5193756724 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA91031FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Florida, Inc CurrentSince Jan 1, 2005 Accepting new patients
Overflow Health Alliance Inc Past Accepting new patients

Locations

119 Oakfield Dr
Brandon, FL 33511
Phone (813) 571-5150

1200 Riverplace Blvd
Ste 620
Jacksonville, FL 32207
Phone (904) 396-6620

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

2029 Professional Center Dr
Orange Park, FL 32073
Phone (570) 352-3063

6000 49th St N
St Petersburg, FL 33709
Phone (727) 521-4411

3030 W Bearss Ave
Tampa, FL 33618
Phone (813) 932-2222

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1093731283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5045 SOUTEL DR STE 12",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322081885",
            "telephone_number": "904-446-8794",
            "fax_number": "904-396-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5045 SOUTEL DR STE 12",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322081885",
            "telephone_number": "190-446-8794",
            "fax_number": "904-468-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOENING",
        "first_name": "LAWRENCE",
        "middle_name": "EDWARD",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA91031",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9103141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292818300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.