Jeri Anice Dyson, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME94306 Issued in FL

Practice address

655 W 8TH St
Ufjp Pediatrics
Jacksonville, FL 32209-6511

Phone

(904) 244-7260

Fax

(904) 244-4845

NPI assigned

Mar 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1142121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238544000000",
    "number": "1144298498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44008",
            "address_2": "UFJP PROVIDER ENROLLMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "address_2": "UFJP PEDIATRICS",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-7260",
            "fax_number": "904-244-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYSON",
        "first_name": "JERI",
        "middle_name": "ANICE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-12",
        "last_updated": "2009-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME94306",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME94306",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "765179961A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2737558-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; 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.