NPIMap

Organization Active NPI

Southeastern Hand Center, P.a.

  • Orthopaedic Hand Surgery Physician
  • Jacksonville, FL
National Provider Identifier
1174615918
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
ME27693 Issued in FL
Legal business name
SOUTHEASTERN HAND CENTER, P.A.
Practice address
6100 Kennerly Rd
Suite 202
Jacksonville, FL 32216-4368
Phone
(904) 733-5550
Fax
(904) 733-5515
NPI assigned
Sep 29, 2006
Last updated
Oct 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Authorized official

Name
Dr. Jack Leeland Greider Jr., MDNPI 1316038615
Title
President
Phone
(904) 733-5550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XS0106X ME27693 FL Primary

Addresses

Primary practice location

6100 Kennerly Rd
Suite 202
Jacksonville, FL 32216-4368

Mailing address

6100 Kennerly Rd
Suite 202
Jacksonville, FL 32216-4368
Phone (904) 733-5550

Other identifiers 1

IdentifierTypeStateIssuer
37943300MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1174615918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 KENNERLY RD",
            "address_2": "SUITE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164368",
            "telephone_number": "904-733-5550",
            "fax_number": "904-733-5515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 KENNERLY RD",
            "address_2": "SUITE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164368",
            "telephone_number": "904-733-5550",
            "fax_number": "904-733-5515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN HAND CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "GREIDER",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "LEELAND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-733-5550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "FL",
            "license": "ME27693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37943300",
            "state": "FL"
        }
    ],
    "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 Oct 26, 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.