NPIMap

Organization Active NPI

Anesthesia Associates of Clay County

  • Anesthesiology Physician
  • Orange Park, FL
National Provider Identifier
1326040908
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ANESTHESIA ASSOCIATES OF CLAY COUNTY
Practice address
1665 Kingsley Ave
Suite 105
Orange Park, FL 32073-4490
Phone
(904) 215-7015
NPI assigned
Aug 12, 2005
Last updated
Jan 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Authorized official

Name
Judy Payne
Title
Credentialing
Phone
(904) 421-2119

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X

Addresses

Primary practice location

1665 Kingsley Ave
Suite 105
Orange Park, FL 32073-4490

Mailing address

PO Box 850001
Dept 121
Orlando, FL 32885-0001

Other identifiers 1

IdentifierTypeStateIssuer
060925100MedicaidFL

National Provider Directory

National Provider Directory

Locations

2021 Kingsley Ave
Ste 10
Orange Park, FL 32073

2021 Kingsley Ave
Ste 102
Orange Park, FL 32073
Phone (904) 276-5400

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453334400000",
    "number": "1326040908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850001",
            "address_2": "DEPT 121",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328850001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 KINGSLEY AVE",
            "address_2": "SUITE 105",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734490",
            "telephone_number": "904-215-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIA ASSOCIATES OF CLAY COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-12",
        "last_updated": "2016-01-21",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "904-421-2119"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060925100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; 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.