Individual provider Active NPI

J Paul Reid III

  • Prosthetic/Orthotic Supplier
  • Jacksonville, FL
National Provider Identifier
1164634309
Registry record updated Sep 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
POR86 Issued in FL
Practice address
8563 Argyle Business Loop Ste 3
Jacksonville, FL 32244-6613
Phone
(904) 777-0101
Fax
(904) 594-6155
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X POR86 FL Primary

Addresses

Primary practice location

8563 Argyle Business Loop Ste 3
Jacksonville, FL 32244-6613

Mailing address

8558 Camshire CT
Jacksonville, FL 32244-5985
Phone (904) 777-0101

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
POR86FLMDProsthetic/Orthotic Supplier

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317340800000",
    "number": "1164634309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 CAMSHIRE CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445985",
            "telephone_number": "904-777-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8563 ARGYLE BUSINESS LOOP STE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322446613",
            "telephone_number": "904-777-0101",
            "fax_number": "904-594-6155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "J",
        "middle_name": "PAUL",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2011-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "FL",
            "license": "POR86",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.