NPIMap

Organization Active NPI

Id Consults and Services, PA

  • Infectious Disease Physician
  • Key West, FL
National Provider Identifier
1215353677
Registry record updated Mar 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME114239 Issued in FL
Legal business name
ID CONSULTS AND SERVICES, PA
Practice address
3142 Northside Dr Ste 101
Key West, FL 33040-8012
Phone
(305) 615-3300
NPI assigned
Mar 10, 2014
Last updated
Mar 10, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
ID CONSULTS AND SERVICES, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 10, 2014

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

Authorized official

Name
Dr. Jerry Jackson, MDNPI 1881874584
Title
President
Phone
(305) 615-3300

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME114239 FL
Infectious Disease Physician 207RI0200X ME114239 FL Primary

Addresses

Primary practice location

3142 Northside Dr Ste 101
Key West, FL 33040-8012

Mailing address

513 Olivia St
Key West, FL 33040-7438

National Provider Directory

National Provider Directory
Tax ID family
Id Consults and Services PA2 organizations share this tax ID, including this one
Part of
Id Consults and Services PA

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1394409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394409600000",
    "number": "1215353677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 OLIVIA ST",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330407438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 NORTHSIDE DR STE 101",
            "city": "KEY WEST",
            "state": "FL",
            "postal_code": "330408012",
            "telephone_number": "305-615-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ID CONSULTS AND SERVICES, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ID CONSULTS AND SERVICES, PA",
        "enumeration_date": "2014-03-10",
        "last_updated": "2014-03-10",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-615-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME114239",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME114239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Key West, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2014; 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.