Individual provider Active NPI

Sharyl J Truty, MD

  • Specialist
  • Jacksonville Beach, FL
National Provider Identifier
1093767147
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME91242 Issued in FL
Practice address
572 Jacksonville Dr
Jacksonville Beach, FL 32250-3813
Phone
(904) 930-4774
Fax
(904) 647-2476
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME91242 FL Primary

Addresses

Primary practice location

572 Jacksonville Dr
Jacksonville Beach, FL 32250-3813

Mailing address

572 Jacksonville Dr
Jacksonville Beach, FL 32250-3813
Phone (904) 930-4774

Other identifiers 1

IdentifierTypeStateIssuer
036105329MedicaidIL

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051107000835 FL Practitioner - Family PracticePractitioner - Sports Medicine 2567456544 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
Loyola University of Chicago, Stritch School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

572 Jacksonville Dr
Jacksonville Beach, FL 32250-3813
Phone (904) 930-4774

Hospital & facility affiliations

  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
  • Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME91242FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Solantic of Jacksonville, LLC CurrentSince Jul 14, 2016 Accepting new patients
Balanced Physician Care PA CurrentSince Aug 3, 2015 Accepting new patients
Illinois Bone and Joint Institute Past Accepting new patients
LTR Medical Management Group Inc Past Accepting new patients
First Coast Physical Medicine Inc Past Accepting new patients

Locations

2401 Monument Rd
Jacksonville, FL 32225
Phone (904) 642-0337

2032 Dunn Ave
Jacksonville, FL 32218
Phone (904) 757-2008

572 Jacksonville Dr
Jax Bch, FL 32250
Phone (904) 222-6262

115 Professional Dr
Ste 104
Ponte Vedra Beach, FL 32082
Phone (904) 930-4774

115 Eastpark Dr
Ste 300
Brentwood, TN 37027

Interoperability endpoints

  • Direct secure messaging: sharyl.truty@265489250582532.direct.elationemr.com
  • FHIR API: https://app.meldrx.com/api/fhir/Freedom_IBJI
  • FHIR API: https://epicproxy.et1195.epichosted.com/fhirproxy/api/FHIR/R4/

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1093767147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "572 JACKSONVILLE DR",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503813",
            "telephone_number": "904-930-4774",
            "fax_number": "904-647-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 JACKSONVILLE DR",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503813",
            "telephone_number": "904-930-4774",
            "fax_number": "904-647-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUTY",
        "first_name": "SHARYL",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME91242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105329",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

Verify at the official NPI Registry.