Mark a Smith MD,P.a.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

ME77870 Issued in FL

Legal business name

MARK A SMITH MD,P.A.

Practice address

10095 Beach Blvd Ste 300
Jacksonville, FL 32246-4775

Phone

(904) 997-2221

Fax

(904) 997-2297

NPI assigned

Aug 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark Anthony Smith, M.D.NPI 1871558114

Title

President/Owner

Phone

(904) 997-2221

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Coastal Health Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Anthony Smith, M.D.

  • General Practice Physician
  • Jacksonville, FL
  • NPI 1871558114
  NPD (past) Authorized official

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295744639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10095 BEACH BLVD STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322464775",
            "telephone_number": "904-997-2221",
            "fax_number": "904-997-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10095 BEACH BLVD STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322464775",
            "telephone_number": "904-997-2221",
            "fax_number": "904-997-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A SMITH MD,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "904-997-2221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "FL",
            "license": "ME77870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PRACTITIONER",
            "identifier": "1871558114",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Marjorie G. Cupp
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• Mark C Monroe MD PA
• Mark C. Hofmann, M.D., P.a.
• Mark Dearing,LCSW Inc
• Mark L. Abramson, MD, PA

• All providers in Jacksonville, FL
• Emergency Medical Services (Emergency Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.