Individual provider Active NPI

Steven Chadwick, D.O.

  • Emergency Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1164963419
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
UO5373 Issued in FL
Practice address
841 Prudential Dr Ste 1400
Jacksonville, FL 32207-8364
Phone
(904) 396-5682
NPI assigned
Mar 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X UO5373 FL
Emergency Medicine Physician 207P00000X UO5373 FL Primary

Addresses

Primary practice location

841 Prudential Dr Ste 1400
Jacksonville, FL 32207-8364

Mailing address

4718 French St
Jacksonville, FL 32205-5002
Phone (904) 422-8288

Other practice location 1

655 W 8th St
1st Floor Clinical Center C506
Jacksonville, FL 32209-6511
Phone (904) 244-3817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200608001013 FL Practitioner - Emergency Medicine 1254603889 Reassigns benefits to 1 organization
I20200609001941 GA Practitioner - Emergency Medicine 1254603889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians IncGroup PAC ID 7911811435, 105 clinicians

Practice addresses (Care Compare)

1250 S 18TH St
202 BMC Nassau Wound
Fernandina Beach, FL 32034-4729
Phone (904) 202-2000

1250 S 18TH St
BMC Nassau Ed
Fernandina Beach, FL 32034-1902
Phone (904) 321-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
UO5373FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Inc Emergency Medicine CurrentSince Jun 1, 2020 Accepting new patients
Emergency Physicians Inc Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients

Locations

1250 S 18th St
Ste 202
Fernandina Beach, FL 32034
Phone (904) 202-2000

1747 Baptist Clay Dr
Ste 250
Fleming Isle, FL 32003
Phone (904) 516-1000

841 Prudential Dr
Ste 1400
Jacksonville, FL 32207
Phone (904) 202-2000

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1489881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1164963419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4718 FRENCH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322055002",
            "telephone_number": "904-422-8288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR STE 1400",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078364",
            "telephone_number": "904-396-5682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 W 8th St",
            "address_2": "1st Floor Clinical Center C506",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-244-3817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHADWICK",
        "first_name": "STEVEN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-19",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "UO5373",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "UO5373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.