Individual provider Active NPI

Jaynell Smith-Cameron, DPM

  • Foot & Ankle Surgery Podiatrist
  • Jacksonville, FL
National Provider Identifier
1235276189
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO002487 Issued in FL
Practice address
2105 Park St
Ste B
Jacksonville, FL 32204-3871
Phone
(904) 354-1192
Fax
(904) 354-1193
NPI assigned
Jan 31, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO002487 FL Primary

Addresses

Primary practice location

2105 Park St
Ste B
Jacksonville, FL 32204-3871

Mailing address

PO Box 2588
Jacksonville, FL 32203-2588
Phone (904) 354-1192

Other identifiers 3

IdentifierTypeStateIssuer
340105700MedicaidFL
40029653OtherFLRAILROAD MEDICARE
65404OtherFLBCBSFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071102000037 FL Practitioner - Podiatry 6901993237 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3115 Spring Glen Rd
Suite 507
Jacksonville, FL 32207-5907
Phone (904) 294-1192

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1354
Removal or shaving of skin growth45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO002487FLMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Services by Jaynell M Smith-Cameron Foot & Ankle Surgery CurrentSince Mar 17, 2023 Accepting new patients
30 Minute Medical LLC Past Accepting new patients
Dr. Zain Barnouti LLC Foot & Ankle Surgery PastSince Apr 2, 2016 Accepting new patients
William J Namen II DPM PA Foot & Ankle Surgery Past Accepting new patients
30 Minute Medical Primary Care Past Accepting new patients

Locations

3115 Spring Glen Rd
Ste 507
Jacksonville, FL 32207
Phone (904) 294-1192

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1235276189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2588",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322032588",
            "telephone_number": "904-354-1192",
            "fax_number": "904-354-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 PARK ST",
            "address_2": "STE B",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043871",
            "telephone_number": "904-354-1192",
            "fax_number": "904-354-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-CAMERON",
        "first_name": "JAYNELL",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO002487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340105700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "40029653",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSFL",
            "identifier": "65404",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.