Clay Internal Medicine PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0053362 Issued in FL

Legal business name

CLAY INTERNAL MEDICINE PA

Practice address

1406 Kingsley Ave Ste D
Orange Park, FL 32073-4528

Phone

(904) 541-1780

Fax

(904) 541-1785

NPI assigned

Feb 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Bruce Chesler, M.D.NPI 1639258221

Title

President

Phone

(904) 541-1780

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.683093

Practitioners 1

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

• Jeffrey Bruce Chesler I, MD

  • Internal Medicine Physician
  • Orange Park, FL
  • NPI 1639258221
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340582400000",
    "number": "1205973682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 KINGSLEY AVE",
            "address_2": "SUITE D",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734590",
            "telephone_number": "904-541-1780",
            "fax_number": "904-541-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 KINGSLEY AVE STE D",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734528",
            "telephone_number": "904-541-1780",
            "fax_number": "904-541-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY INTERNAL MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2012-06-25",
        "status": "A",
        "authorized_official_last_name": "CHESLER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-541-1780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0053362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clay Behavioral Health Center, Inc.
• Clay Behavioral Health Center, Inc.
• Clay Behavioral Health Center, Inc.
• Clay Chiropractic and Rehabilitation
• Clay County Medical Investors, LLC (Life Care Center of Orange Park)
• Clay Pain Center Physicians LLC
• Clay Physical Therapy PA
• Clay Primary & Family Care LLC
• Clay Pulmonary Services PA
• Clay Surgery Center LLP

• Internal Medicine Physician in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; 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.