John Axley, M.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

ME20237 Issued in FL

Practice address

4400 Bayou Blvd Ste 43
Pensacola, FL 32503-1910

Phone

(850) 477-3015

Fax

(850) 477-3026

NPI assigned

Nov 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1164595427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 BAYOU BLVD STE 43",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325031910",
            "telephone_number": "850-477-3015",
            "fax_number": "850-477-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 BAYOU BLVD STE 43",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325031910",
            "telephone_number": "850-477-3015",
            "fax_number": "850-477-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AXLEY",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME20237",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AL",
            "license": "00007052",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009945805",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052598700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB PTAN",
            "identifier": "406132045",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Avalon Medical Group
• Avenir Ventures, L.L.C.
• Awaken Brain Health
• Frank Orla Axelsen, M.D.
• Debra Axley, ARNP
• John Charles Axley
• Page Druce Axley, M.D.
• George R Aycock Jr., MD
• Ryan Don Aycock
• Tammie Aycox

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.

Verify at the official NPI Registry.