Active NPI
Seabury Dennison Stoneburner Jr., MD
- Nephrology Physician
- Jacksonville, FL
National Provider Identifier
1154315984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- ME28584
- Practice address
- 3 Shircliff Way
Suite 658
Jacksonville, FL 32204 - Phone
- (904) 389-9681
- Fax
- (904) 389-7975
- NPI assigned
- Sep 8, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | ME28584 | FL | Primary |
Addresses
Primary practice location
3 Shircliff Way
Suite 658
Jacksonville, FL 32204
Mailing address
3 Shircliff Way
Suite 658
Jacksonville, FL 32204
Phone (904) 389-9681
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 058252200 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME28584 | FL | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214265600000",
"number": "1154315984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 SHIRCLIFF WAY",
"address_2": "SUITE 658",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32204",
"telephone_number": "904-389-9681",
"fax_number": "904-389-7975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 SHIRCLIFF WAY",
"address_2": "SUITE 658",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32204",
"telephone_number": "904-389-9681",
"fax_number": "904-389-7975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STONEBURNER",
"first_name": "SEABURY",
"middle_name": "DENNISON",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-08",
"last_updated": "2008-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "FL",
"license": "ME28584",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "058252200",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}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 Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.