Active NPI
Jax Psychiatry LLC
- Psychiatry Physician
- Ponte Vedra, FL
National Provider Identifier
1124538525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- 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
- Last updated
- Oct 12, 2021
- Organization subpart
- No
NPPES NPI Registry
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
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | Primary |
Addresses
Primary practice location
145 Hilden Rd Ste 108
Ponte Vedra, FL 32081-8401
Mailing address
145 Hilden Rd Ste 108
Ponte Vedra, FL 32081-8401
Phone (904) 834-1242
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- Psychiatry Physician
- Jacksonville, FL
- NPI 1023244381
NPI Registry JSON
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": []
}
Other providers in Ponte Vedra, FL
Sources for this page
- 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.