Active NPI
Eugene Joseph Rankin, PH.D.
- Clinical Neuropsychologist
- St Augustine, FL
National Provider Identifier
1104870930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- PY 6386
- Practice address
- 300 Kingsley Lake Dr
Ste 401
St Augustine, FL 32092-3037 - Phone
- (904) 495-6800
- Fax
- (904) 281-0495
- NPI assigned
- May 19, 2006
- 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 |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | PY 6386 | FL | Primary |
Addresses
Primary practice location
300 Kingsley Lake Dr
Ste 401
St Augustine, FL 32092-3037
Mailing address
300 Kingsley Lake Dr
Ste 401
St Augustine, FL 32092-3037
Phone (904) 495-6800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 6386 | FL | MD | Clinical Neuropsychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Halifax Healthcare Systems Inc | Current | Accepting new patients | |
| Vericare of Florida, Inc. | Past | Accepting new patients | |
| Eugene J. Rankin, PH.D., Abpp, P.L | Past | Accepting new patients |
Locations
201 N Clyde Morris Blvd
Ste 120
Daytona Beach, FL 32114
Phone (386) 254-4029
303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285
Organizations & group practices 3
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.
-
- Adult Mental Health Clinic/Center
- Jacksonville, FL
- NPI 1093993701
-
- Family Medicine Physician
- Daytona Beach, FL
- NPI 1245283530
-
- Clinical Psychologist
- Lakeland, FL
- NPI 1851331086
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477958400000",
"number": "1104870930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 KINGSLEY LAKE DR",
"address_2": "STE 401",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320923037",
"telephone_number": "904-495-6800",
"fax_number": "904-281-0495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 KINGSLEY LAKE DR",
"address_2": "STE 401",
"city": "ST AUGUSTINE",
"state": "FL",
"postal_code": "320923037",
"telephone_number": "904-495-6800",
"fax_number": "904-281-0495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANKIN",
"first_name": "EUGENE",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-19",
"last_updated": "2016-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "FL",
"license": "PY 6386",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in St Augustine, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.