Eric W Shultz DPM PA

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

PO1898 Issued in FL

Legal business name

ERIC W SHULTZ DPM PA

Practice address

10250 Normandy Blvd
Suite 205
Jacksonville, FL 32221-0000

Phone

(904) 551-1765

Fax

(904) 388-8263

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Kelley M Lundeen, DPM

Title

Office Manager

Phone

(904) 551-1765

Specialties & licenses 6

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1326250010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10250 NORMANDY BLVD",
            "address_2": "SUITE 205",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322210000",
            "telephone_number": "904-551-1765",
            "fax_number": "904-527-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10250 NORMANDY BLVD",
            "address_2": "SUITE 205",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322210000",
            "telephone_number": "904-551-1765",
            "fax_number": "904-388-8263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC W SHULTZ DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "LUNDEEN",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-551-1765",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO1898",
            "primary": false
        },
        {
            "code": "213EP0504X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Public Medicine",
            "state": "FL",
            "license": "PO1898",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "FL",
            "license": "PO1898",
            "primary": true
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Radiology",
            "state": "FL",
            "license": "PO1898",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO1898",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO1898",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390193900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "480020923",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "65159",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elisa Ereckson, APRN
• Christina Joelene Erford, DNP, APRN, NP-C
• Ergo Body Inc.
• Michael J. Erhard, MD
• Eric M. Gabriel, M.D., P.a.
• Ericka Ericka Vargas
• Alexander Christian Erickson, IDC
• Edith Carol Erickson, NP
• Jamie Lee Erickson, MS, ATC, LAT
• John Erickson, O.D.

• Primary Podiatric Medicine Podiatrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Primary Podiatric Medicine Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2011; 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.