Organization Active NPI

Hyde Park Medical Arts Inc

  • Sports Medicine (Family Medicine) Physician
  • Jacksonville, FL
National Provider Identifier
1235286527
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
OS7282 Issued in FL
Legal business name
HYDE PARK MEDICAL ARTS INC
Practice address
6671 Hyde Grove Ave
Jacksonville, FL 32210-2839
Phone
(904) 783-3700
Fax
(904) 695-2579
NPI assigned
Jan 5, 2007
Last updated
Dec 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Authorized official

Name
Ms. Rebecca Jane Haynes
Title
Office Manager
Phone
(904) 783-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X OS7282 FL Primary

Addresses

Primary practice location

6671 Hyde Grove Ave
Jacksonville, FL 32210-2839

Mailing address

6671 Hyde Grove Ave
Jacksonville, FL 32210-2839
Phone (904) 783-3700

Other identifiers 1

IdentifierTypeStateIssuer
264729000MedicaidFL

National Provider Directory

National Provider Directory

Locations

1634 Blanding Blvd
Jacksonville, FL 32210
Phone (904) 389-3811

6671 Hyde Grove Ave
Jacksonville, FL 32210
Phone (904) 783-3700

Practitioners & affiliated clinicians

Practitioners 4

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": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1235286527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6671 HYDE GROVE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102839",
            "telephone_number": "904-783-3700",
            "fax_number": "904-695-2579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6671 HYDE GROVE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102839",
            "telephone_number": "904-783-3700",
            "fax_number": "904-695-2579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PARK MEDICAL ARTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-783-3700",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "OS7282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264729000",
            "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 Dec 17, 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.