Individual provider Active NPI

Donald N Pyle II, D.O.

  • Psychiatry Physician
  • Jacksonville, FL
National Provider Identifier
1295041325
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
OS11841 Issued in FL
Practice address
145 Heron Bay Rd
Jacksonville, FL 32218-3595
Phone
(904) 470-6900
NPI assigned
Aug 26, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 0102204779 VA
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X OS11841 FL
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X C2-0010991 DE
Psychiatry Physician 2084P0800X C2-0010991 DE
Psychiatry Physician 2084P0800X 0102204779 VA
Psychiatry Physician 2084P0800X OS11841 FL Primary

Addresses

Primary practice location

145 Heron Bay Rd
Jacksonville, FL 32218-3595

Mailing address

145 Heron Bay Rd
Jacksonville, FL 32218-3595
Phone (904) 470-6900

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
C2-0010991DEMDPsychiatry Physician
OS11841FLMDPsychiatry Physician
0102204779VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Pavia Healthcare Center PastSince Oct 6, 2024 Accepting new patients
Western Tidewater Community Mental Psychiatry PastSince May 4, 2012 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1295041325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 HERON BAY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322183595",
            "telephone_number": "904-470-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HERON BAY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322183595",
            "telephone_number": "904-470-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYLE",
        "first_name": "DONALD",
        "middle_name": "N",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-26",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "VA",
            "license": "0102204779",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "FL",
            "license": "OS11841",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "DE",
            "license": "C2-0010991",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "DE",
            "license": "C2-0010991",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102204779",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "OS11841",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 2, 2024; 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.