Jax Psychiatry LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

JAX PSYCHIATRY LLC

Practice address

145 Hilden Rd Ste 108
Ponte Vedra, FL 32081-8401

Phone

(904) 834-1242

NPI assigned

Oct 11, 2017

Organization subpart

No

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

Authorized official

Name

Riaz Ahmed, M.D.

Title

M.D./ President

Phone

(904) 834-8042

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1507680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1124538525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HILDEN RD STE 108",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320818401",
            "telephone_number": "904-834-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HILDEN RD STE 108",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320818401",
            "telephone_number": "904-834-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAX PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-11",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "AHMED",
        "authorized_official_first_name": "RIAZ",
        "authorized_official_title_or_position": "M.D./ PRESIDENT",
        "authorized_official_telephone_number": "904-834-8042",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.