NPIMap

Organization Active NPI

The Medical Imaging Partnership - Jax1 LLC

Doing business as Precision Imaging Laboratory

  • Clinical Medical Laboratory
  • Jacksonville, FL
National Provider Identifier
1336915776
Registry record updated Nov 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
THE MEDICAL IMAGING PARTNERSHIP - JAX1 LLC
Doing business as
Precision Imaging Laboratory
Practice address
6800 Southpoint Pkwy Ste 950
Jacksonville, FL 32216-8203
Phone
(904) 648-8600
Fax
(904) 389-8699
NPI assigned
Nov 28, 2023
Last updated
Nov 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2023

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

Authorized official

Name
Joshua Hammond
Title
Ceo
Phone
(904) 996-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

6800 Southpoint Pkwy Ste 950
Jacksonville, FL 32216-8203

Mailing address

1540 Business Center Dr
Fleming Island, FL 32003-4418
Phone (904) 996-8100

Other names 1

  • Precision Imaging Laboratory Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240112002296 FL Part B Supplier - Independent Clinical Laboratory 1850482381 Practice locations: Jacksonville, FL

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
The Medical Imaging Partnership - Jax1 LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1540 Business Center Dr
Fleming Island, FL 32003

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1336915776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 BUSINESS CENTER DR",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034418",
            "telephone_number": "904-996-8100",
            "fax_number": "904-389-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 SOUTHPOINT PKWY STE 950",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168203",
            "telephone_number": "904-648-8600",
            "fax_number": "904-389-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEDICAL IMAGING PARTNERSHIP - JAX1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-28",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-996-8100"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Precision Imaging Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.