Individual provider Active NPI

William Craig Danzeisen, D.P.M.

  • Podiatrist
  • Jacksonville, FL
National Provider Identifier
1205263241
Registry record updated Aug 26, 2016
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective May 20, 2019.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO1571 Issued in FL
Practice address
8640 Philips Hwy
Ste 10
Jacksonville, FL 32256-1207
Phone
(904) 469-2432
Fax
(904) 779-3348
NPI assigned
Oct 6, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO1571 FL Primary

Addresses

Primary practice location

8640 Philips Hwy
Ste 10
Jacksonville, FL 32256-1207

Mailing address

8640 Philips Hwy
Ste 10
Jacksonville, FL 32256-1207
Phone (904) 469-2432

Other identifiers 1

IdentifierTypeStateIssuer
016978300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

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. Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
On Site Dermatology LLC Past Accepting new patients
Boca Deerfield Foot Care Center Inc Past Accepting new patients

Organizations & group practices 2

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": "1381017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472169600000",
    "number": "1205263241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8640 PHILIPS HWY",
            "address_2": "STE 10",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322561207",
            "telephone_number": "904-469-2432",
            "fax_number": "904-779-3348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8640 PHILIPS HWY",
            "address_2": "STE 10",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322561207",
            "telephone_number": "904-469-2432",
            "fax_number": "904-779-3348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANZEISEN",
        "first_name": "WILLIAM",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-06",
        "last_updated": "2016-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO1571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016978300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.