Individual provider Active NPI

Lawrence Arthur Solberg Jr., M.D. PH.D.

  • Hematology & Oncology Physician
  • Jacksonville, FL
National Provider Identifier
1124017850
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
ME60970 Issued in FL
Practice address
3827 Coopers Lake Rd
Jacksonville, FL 32224-8436
Phone
(904) 223-3146
NPI assigned
Oct 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X ME60970 FL Primary

Addresses

Primary practice location

3827 Coopers Lake Rd
Jacksonville, FL 32224-8436

Mailing address

3827 Coopers Lake Rd
Jacksonville, FL 32224-8436
Phone (904) 223-3146

Other identifiers 3

IdentifierTypeStateIssuer
830001042OtherFLRAILROAD MEDICARE
14296OtherFLBLUECROSS/BLUESHIELD
371817400MedicaidFL

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
I20160519001038 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9133285737

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME60970FLMDHematology & Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1129334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1124017850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3827 COOPERS LAKE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322248436",
            "telephone_number": "904-223-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3827 COOPERS LAKE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322248436",
            "telephone_number": "904-223-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLBERG",
        "first_name": "LAWRENCE",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D. PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-15",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "FL",
            "license": "ME60970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "830001042",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "14296",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371817400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.