Johnny N Jada, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME52918 Issued in FL

Practice address

3550 University Blvd S
Ste 206
Jacksonville, FL 32216-4246

Phone

(904) 723-0015

Fax

(904) 723-5665

NPI assigned

Nov 8, 2005

Last updated

Jan 26, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Johnny Jada MD

  • Pediatrics Physician
  • Jacksonville, FL
  • NPI 1154736304
  NPD (past) Authorized official

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327536000000",
    "number": "1184605057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17809",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322457809",
            "telephone_number": "904-723-0015",
            "fax_number": "904-723-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 UNIVERSITY BLVD S",
            "address_2": "STE 206",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164246",
            "telephone_number": "904-723-0015",
            "fax_number": "904-723-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JADA",
        "first_name": "JOHNNY",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2012-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME52918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "103945",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "27285",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378546700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHEASE",
            "identifier": "11498",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie Stark Jacobson, M.D.
• Arielle Jacover, MD
• Jeffry Alan Jacqmein, MD
• Lisa H. Jacquet, ARNP
• Alana Jada, MD
• Amair Ayman Jadallah
• Jade Greene Bcba LLC
• Jaswant S Jadeja, MD
• Sonal Jadeja
• Jades Caring Hands LLC

• Pediatrics Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.