Organization Active NPI

John Canterbury PA

  • Internal Medicine Physician
  • Miami, FL
National Provider Identifier
1174710123
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
JOHN CANTERBURY PA
Practice address
601 NE 36TH St
Suite 3411
Miami, FL 33137-3914
Phone
(305) 323-2095
NPI assigned
Oct 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Authorized official

Name
Dr. John Peter Canterbury, MDNPI 1316951148
Title
President
Phone
(305) 323-2095

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

601 NE 36TH St
Suite 3411
Miami, FL 33137-3914

Mailing address

601 NE 36TH St
Suite 3411
Miami, FL 33137-3914
Phone (305) 323-2095

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071126000692 FL Part B Supplier - Clinic/Group Practice 5092803130 Receives reassigned benefits from 5 practitioners
Practice locations: Naples, FL; Bonita Springs, FL
O20210203000715 GA Part B Supplier - Clinic/Group Practice 5092803130 Practice locations: Albany, GA

National Provider Directory

National Provider Directory

Locations

19 Bald Eagle Dr
Ste G
Marco Island, FL 34145
Phone (239) 206-2880

2500 Tamiami Trl N
Ste 102
Naples, FL 34103
Phone (239) 206-2880

680 2nd Ave N
Ste 203
Naples, FL 34102
Phone (239) 261-2312

110 Logan Ct
Albany, GA 31707
Phone (229) 883-1119

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1174710123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 NE 36TH ST",
            "address_2": "SUITE 3411",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331373914",
            "telephone_number": "305-323-2095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 NE 36TH ST",
            "address_2": "SUITE 3411",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331373914",
            "telephone_number": "305-323-2095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN CANTERBURY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-03",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "CANTERBURY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-323-2095",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.