NPIMap

Organization Active NPI

Jacksonville Orthopaedic Institute Inc

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1124176540
Registry record updated Jan 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
JACKSONVILLE ORTHOPAEDIC INSTITUTE INC
Practice address
1325 San Marco Blvd
Suite 102
Jacksonville, FL 32207-8568
Phone
(904) 557-9021
Fax
(904) 557-9022
NPI assigned
Jan 8, 2007
Last updated
Jan 8, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2019

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

Authorized official

Name
Mr. Timothy Edwin Wall, MS. ATCNPI 1346263969
Title
Administrator
Phone
(904) 858-7045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X FL Primary
Athletic TrainerGroup: 193200000X MULTI-SPECIALTY GROUP 2255A2300X AL351 FL
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X FL

Addresses

Primary practice location

1325 San Marco Blvd
Suite 102
Jacksonville, FL 32207-8568

Mailing address

PO Box 117345
Atlanta, GA 30368-7345
Phone (904) 346-3465

Other names 1

  • Jacksonville Orthopaedic Institute Rehabilitation Other name

National Provider Directory

National Provider Directory
Tax ID family
Jacksonville Orth Inst27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

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": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546905600000",
    "number": "1124176540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117345",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303687345",
            "telephone_number": "904-346-3465",
            "fax_number": "904-858-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 SAN MARCO BLVD",
            "address_2": "SUITE 102",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078568",
            "telephone_number": "904-557-9021",
            "fax_number": "904-557-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE ORTHOPAEDIC INSTITUTE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2019-01-08",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-858-7045",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS. ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL351",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacksonville Orthopaedic Institute Rehabilitation",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Jacksonville Orthopaedic Institute Rehabilitation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.