Neurology Associates of Starke Inc

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME68599 Issued in FL

Legal business name

NEUROLOGY ASSOCIATES OF STARKE INC

Practice address

107 Edwards Rd
Suite F
Starke, FL 32091-3959

Phone

(904) 368-8111

Fax

(904) 368-8103

NPI assigned

Apr 26, 2012

Last updated

Apr 26, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John Decerce, M.D.NPI 1497724421

Title

Owner

Phone

(904) 368-8111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

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.

• John Decerce, MD

  • Neurology Physician
  • Starke, FL
  • NPI 1497724421
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1154689289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 EDWARDS RD",
            "address_2": "SUITE F",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320913959",
            "telephone_number": "904-368-8111",
            "fax_number": "904-368-8103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 EDWARDS RD",
            "address_2": "SUITE F",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320913959",
            "telephone_number": "904-368-8111",
            "fax_number": "904-368-8103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROLOGY ASSOCIATES OF STARKE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "DECERCE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-368-8111",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME68599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nicole Latrece Nichols, LMHC

• Neurology Physician in Starke, FL
• Providers in Starke, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.