Dr. Mary's Place

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

ARNP9271693 Issued in FL

Legal business name

DR. MARY'S PLACE

Practice address

4051 Atlantic Blvd
Jacksonville, FL 32207-2036

Phone

(904) 393-4700

Fax

(904) 493-9700

NPI assigned

Dec 10, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Cara Marie D'Amico, C-PNP, ARNP

Title

Pediatric Arnp

Phone

(904) 642-6100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304035200000",
    "number": "1164751707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4051 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072036",
            "telephone_number": "904-393-4700",
            "fax_number": "904-493-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072036",
            "telephone_number": "904-393-4700",
            "fax_number": "904-493-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARY'S PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2011-04-29",
        "status": "A",
        "authorized_official_last_name": "D'AMICO",
        "authorized_official_first_name": "CARA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PEDIATRIC ARNP",
        "authorized_official_telephone_number": "904-642-6100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "C-PNP, ARNP"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP9271693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.