Organization Active NPI

JMJ Family Practice Inc

  • Primary Care Clinic/Center
  • Kissimmee, FL
National Provider Identifier
1295828887
Registry record updated Sep 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
JMJ FAMILY PRACTICE INC
Practice address
300 N. John Young Pkwy
Kissimmee, FL 34741
Phone
(407) 935-9012
Fax
(407) 935-9108
NPI assigned
Oct 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2019

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

Authorized official

Name
Dr. Jose Ramon FernandezNPI 1063516284
Title
Medical Doctor / Owner
Phone
(407) 935-9012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

300 N. John Young Pkwy
Kissimmee, FL 34741

Mailing address

300 N John Young Pkwy
Kissimmee, FL 34741-4902
Phone (407) 935-9012

Other practice location 1

2040 Highway A1A Ste 209
Indian Harbour Beach, FL 32937-3566
Phone (321) 425-2233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050811000598 FL Part B Supplier - Clinic/Group Practice 2264461011 Receives reassigned benefits from 6 practitioners
Practice locations: Kissimmee, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1046032JMJ Family Practice300 N John Young Pkwy, Kissimmee, FL 34741Certificate of waiverSep 28, 2027

National Provider Directory

National Provider Directory

Locations

300 N John Young Pkwy
Kissimmee, FL 34741
Phone (407) 935-9012

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10787/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568246400000",
    "number": "1295828887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414902",
            "telephone_number": "407-935-9012",
            "fax_number": "407-935-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 N. JOHN YOUNG PKWY",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "34741",
            "telephone_number": "407-935-9012",
            "fax_number": "407-935-9108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2040 Highway A1A Ste 209",
            "address_purpose": "LOCATION",
            "city": "Indian Harbour Beach",
            "state": "FL",
            "postal_code": "329373566",
            "country_code": "US",
            "telephone_number": "321-425-2233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JMJ FAMILY PRACTICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2019-09-12",
        "status": "A",
        "authorized_official_last_name": "FERNANDEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "RAMON",
        "authorized_official_title_or_position": "MEDICAL DOCTOR / OWNER",
        "authorized_official_telephone_number": "407-935-9012",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.