NPIMap

Organization Active NPI

East Coast Pathology of Florida, PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Ormond Beach, FL
National Provider Identifier
1154601912
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
EAST COAST PATHOLOGY OF FLORIDA, PA
Practice address
595 N Nova Rd Ste 118
Ormond Beach, FL 32174-4429
Phone
(386) 235-9058
NPI assigned
Aug 25, 2011
Last updated
Mar 27, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Authorized official

Name
Crystal P Jenkins, M.D.NPI 1750464152
Title
Managing Director
Phone
(386) 235-9058

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

595 N Nova Rd Ste 118
Ormond Beach, FL 32174-4429

Mailing address

595 N Nova Rd Ste 118
Ormond Beach, FL 32174-4429
Phone (386) 235-9058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120124000577 FL Part B Supplier - Clinic/Group Practice 1355518812 Receives reassigned benefits from 13 practitioners
Practice locations: Daytona Beach, FL; Palm Coast, FL; Orange City, FL; New Smyrna Beach, FL; Deland, FL

National Provider Directory

National Provider Directory

Locations

301 Memorial Medical Pkwy
Daytona Beach, FL 32117
Phone (386) 231-3906

595 N Nova Rd
Ste 118
Ormond Beach, FL 32174
Phone (386) 231-3523

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774569600000",
    "number": "1154601912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 N NOVA RD STE 118",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321744429",
            "telephone_number": "386-235-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 N NOVA RD STE 118",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321744429",
            "telephone_number": "386-235-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COAST PATHOLOGY OF FLORIDA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-25",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A",
        "authorized_official_last_name": "JENKINS",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "386-235-9058",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.