Active NPI
David Boyd, M.D.
- Dermatology Physician
- Jacksonville, FL
National Provider Identifier
1164401311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- ME111184
- Practice address
- 4100 Southpoint Dr E
Suite 1
Jacksonville, FL 32216-8017 - Phone
- (904) 854-2550
- Fax
- (904) 854-2555
- NPI assigned
- Jan 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 45013-020 | WI | |
| Dermatology Physician | 207N00000X | ME111184 | FL | Primary |
Addresses
Primary practice location
4100 Southpoint Dr E
Suite 1
Jacksonville, FL 32216-8017
Mailing address
2600 Lake Lucien Dr
Suite 180
Maitland, FL 32751-7233
Phone (407) 875-2080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007651300 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME111184 | FL | MD | Dermatology Physician |
| 45013-020 | WI | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Clinical Practice Association Inc | Current | Accepting new patients | |
| Florida Clinical Practice Association Inc | Current | Accepting new patients |
Locations
2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990
1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Surgery Physician
- Gainesville, FL
- NPI 1063463768
-
- Durable Medical Equipment & Medical Supplies
- Ocala, FL
- NPI 1609529478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433289600000",
"number": "1164401311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 LAKE LUCIEN DR",
"address_2": "SUITE 180",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327517233",
"telephone_number": "407-875-2080",
"fax_number": "407-875-0518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 SOUTHPOINT DR E",
"address_2": "SUITE 1",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322168017",
"telephone_number": "904-854-2550",
"fax_number": "904-854-2555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-14",
"last_updated": "2015-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "WI",
"license": "45013-020",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "FL",
"license": "ME111184",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007651300",
"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 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.