NPIMap

Organization Active NPI

Michelle McLanahan, M.D., P.a.

  • Specialist
  • Jacksonville, FL
National Provider Identifier
1225226038
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME69467 Issued in FL
Legal business name
MICHELLE MCLANAHAN, M.D., P.A.
Practice address
8075 Gate Pkwy W
#305
Jacksonville, FL 32216-3684
Phone
(904) 296-2992
Fax
(904) 296-2993
NPI assigned
Oct 5, 2007
Last updated
Mar 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Authorized official

Name
Dr. Michelle McLanahan, M.D.NPI 1245221605
Title
Owner
Phone
(904) 296-2992

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME69467 FL Primary

Addresses

Primary practice location

8075 Gate Pkwy W
#305
Jacksonville, FL 32216-3684

Mailing address

8075 Gate Pkwy W
#305
Jacksonville, FL 32216-3684
Phone (904) 296-2992

Other identifiers 1

IdentifierTypeStateIssuer
002817200MedicaidFL

National Provider Directory

National Provider Directory

Locations

4205 Belfort Rd
Ste 2060
Jacksonville, FL 32216
Phone (904) 296-2992

4600 Touchton Rd E
Bldg 100
Jacksonville, FL 32246

8075 Gate Pkwy W
Ste 305
Jacksonville, FL 32216
Phone (904) 269-2992

1555 Atlantic Blvd
Neptune Beach, FL 32266
Phone (904) 241-0327

Practitioners & affiliated clinicians

Practitioners 3

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": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1225226038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8075 GATE PKWY W",
            "address_2": "#305",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163684",
            "telephone_number": "904-296-2992",
            "fax_number": "904-296-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8075 GATE PKWY W",
            "address_2": "#305",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163684",
            "telephone_number": "904-296-2992",
            "fax_number": "904-296-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE MCLANAHAN, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "MCLANAHAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-296-2992",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME69467",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002817200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.