Dovetail Orthopedics, LLC

Primary specialty

Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X

Legal business name

DOVETAIL ORTHOPEDICS, LLC

Practice address

2416 Lynndale Rd Ste 102
Fernandina Beach, FL 32034-5201

Phone

(904) 430-7132

Fax

(904) 601-1512

NPI assigned

Oct 10, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Robert D. Santrock, M.D.NPI 1497731780

Title

Owner

Phone

(304) 216-7960

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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

• Robert D Santrock, M.D.

  • Orthopaedic Surgery Physician
  • Fernandina Beach, FL
  • NPI 1497731780

  Foot and Ankle Surgery

  Medicare reassignment Care Compare group NPD Authorized official
• Mark William Floyd, MD

  • Orthopaedic Surgery Physician
  • Fernandina Beach, FL
  • NPI 1811158249
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1336920016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 LYNNDALE RD STE 102",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320345201",
            "telephone_number": "904-430-7132",
            "fax_number": "904-601-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2416 LYNNDALE RD STE 102",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320345201",
            "telephone_number": "904-430-7132",
            "fax_number": "904-601-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOVETAIL ORTHOPEDICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "SANTROCK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-216-7960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Todd Devane, M.D.
• Diana R Twiggs MD (Amelia Island Family Medicine PLC)
• Benjamin Nolan Diller, D.D.S.
• JB Donaldson Jr., BSN-RN
• Eamon Michael Donovan, PTA
• Julieann Drake, PTA
• Catherine Drew, PHD
• William Fletcher Drewry Jr., MD
• Deborah Dufresne, IMH
• Danielle Dumont, LPAT, ATR-BC

• Orthopaedic Foot and Ankle Surgery Physician in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Orthopaedic Foot and Ankle Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.