Individual provider Active NPI

John Thomas Sladky, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Gainesville, FL
National Provider Identifier
1174550388
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
ME123731 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-0001
Phone
(352) 273-8920
Fax
(352) 392-9802
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 041219 GA
Pediatrics Physician 208000000X ME123731 FL
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X ME123731 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-0001

Mailing address

PO Box 100296
Gainesville, FL 32610-0296
Phone (352) 273-8920

Other identifiers 2

IdentifierTypeStateIssuer
000686694CMedicaidGA
014945300MedicaidFL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150626000870 FL Practitioner - Pediatric Medicine 1153633557 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME123731FLMDPediatrics Physician
041219GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince May 21, 2015 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince May 21, 2015 Accepting new patients
Emory Childrens Center Pediatrics Past 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 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1174550388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100296",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100296",
            "telephone_number": "352-273-8920",
            "fax_number": "352-392-9802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100001",
            "telephone_number": "352-273-8920",
            "fax_number": "352-392-9802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLADKY",
        "first_name": "JOHN",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "041219",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME123731",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "FL",
            "license": "ME123731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000686694C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014945300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.