Jacksonville Aristo ER, LLC

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

JACKSONVILLE ARISTO ER, LLC

Practice address

1701 Pelham Rd S
Jacksonville, AL 36265-3353

Phone

(256) 435-4970

Fax

(205) 313-5298

NPI assigned

Dec 7, 2015

Last updated

Dec 7, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

ARISTO ERAs reported in NPPES

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

Authorized official

Name

Mr. Charles Rich Street Jr.

Title

Ceo/Owner

Phone

(205) 313-5202

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449446400000",
    "number": "1316312028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830525",
            "address_2": "DEPT# SF54",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352830525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 PELHAM RD S",
            "city": "JACKSONVILLE",
            "state": "AL",
            "postal_code": "362653353",
            "telephone_number": "256-435-4970",
            "fax_number": "205-313-5298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE ARISTO ER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARISTO ER",
        "enumeration_date": "2015-12-07",
        "last_updated": "2015-12-07",
        "status": "A",
        "authorized_official_last_name": "STREET",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "RICH",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "205-313-5202",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emergency Medicine Physician in Jacksonville, AL
• Providers in Jacksonville, AL by specialty
• Emergency Medicine Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; 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.