Active NPI
Roell T Milbry Jr.
- Community Health Worker
- Jacksonville, FL
National Provider Identifier
1245490796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 8700 Southside Blvd Apt 313
Jacksonville, FL 32256-8478 - Phone
- (904) 982-2407
- NPI assigned
- Jun 9, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
8700 Southside Blvd Apt 313
Jacksonville, FL 32256-8478
Mailing address
PO Box 23277
Jacksonville, FL 32241-3277
Phone (904) 982-2407
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 687829696 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212969600000",
"number": "1245490796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 23277",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322413277",
"telephone_number": "904-982-2407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8700 SOUTHSIDE BLVD APT 313",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322568478",
"telephone_number": "904-982-2407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILBRY",
"first_name": "ROELL",
"middle_name": "T",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-09",
"last_updated": "2008-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "687829696",
"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 Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.