NPIMap

Organization Active NPI

J & G Medical Associates PA

  • Psychiatric/Mental Health Nurse Practitioner
  • Davie, FL
National Provider Identifier
1184042079
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
J & G MEDICAL ASSOCIATES PA
Practice address
8958 W State Road 84 Ste 342
Davie, FL 33324-4457
Phone
(914) 602-6209
Fax
(954) 357-1175
NPI assigned
Mar 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Authorized official

Name
Mr. Jaison Chakkappan, ARNP
Title
President
Phone
(914) 602-6209

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

8958 W State Road 84 Ste 342
Davie, FL 33324-4457

Mailing address

8958 W State Road 84 Ste 342
Davie, FL 33324-4457
Phone (914) 602-6209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151001001781 FL Part B Supplier - Clinic/Group Practice 2860700408 Receives reassigned benefits from 7 practitioners
Practice locations: Sunrise, FL; North Miami, FL; Riviera Beach, FL; Pompano BH, FL; Pompano Beach, FL; Plantation, FL; Pembroke Pines, FL; Pahokee, FL…

National Provider Directory

National Provider Directory

Locations

1490 NW 21st St
Ft Lauderdale, FL 33311
Phone (954) 462-6610

2770 NW 58th Ter
Lauderhill, FL 33313
Phone (954) 484-3712

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 7

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": "1396051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1184042079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8958 W STATE ROAD 84 STE 342",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333244457",
            "telephone_number": "914-602-6209",
            "fax_number": "954-357-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8958 W STATE ROAD 84 STE 342",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333244457",
            "telephone_number": "914-602-6209",
            "fax_number": "954-357-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J & G MEDICAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-29",
        "last_updated": "2021-08-17",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "CHAKKAPPAN",
        "authorized_official_first_name": "JAISON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "914-602-6209",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.