NPIMap

Organization Active NPI

Medical Neurodiagnostics & Neurology PL

  • Specialist
  • Orange Park, FL
National Provider Identifier
1134443583
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
PA9101871 Issued in FL
Legal business name
MEDICAL NEURODIAGNOSTICS & NEUROLOGY PL
Practice address
1536 Kingsley Ave Ste 116
Orange Park, FL 32073-4525
Phone
(904) 723-5665
Fax
(904) 338-0951
NPI assigned
Mar 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Authorized official

Name
Ron Baugh, PA
Title
President
Phone
(904) 723-5665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X PA9101871 FL Primary

Addresses

Primary practice location

1536 Kingsley Ave Ste 116
Orange Park, FL 32073-4525

Mailing address

PO Box 17809
Jacksonville, FL 32245-7809
Phone (904) 723-5665

National Provider Directory

National Provider Directory

Locations

1536 Kingsley Ave
Ste 116
Orange Park, FL 32073
Phone (904) 375-1720

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279756800000",
    "number": "1134443583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17809",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322457809",
            "telephone_number": "904-723-5665",
            "fax_number": "904-338-0951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 KINGSLEY AVE STE 116",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734525",
            "telephone_number": "904-723-5665",
            "fax_number": "904-338-0951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL NEURODIAGNOSTICS & NEUROLOGY PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-07-22",
        "status": "A",
        "authorized_official_last_name": "BAUGH",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-723-5665",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "PA9101871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.