Organization Active NPI

Reynaldo G Fermo MD PA

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1346556248
Registry record updated Aug 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
REYNALDO G FERMO MD PA
Practice address
7855 Argyle Forest Blvd
# 804
Jacksonville, FL 32244-5596
Phone
(904) 421-2119
NPI assigned
Aug 30, 2010
Last updated
Aug 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2010

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

Authorized official

Name
Reynalod F Fermo, MD
Title
Owner
Phone
(904) 421-2119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

7855 Argyle Forest Blvd
# 804
Jacksonville, FL 32244-5596

Mailing address

7855 Argyle Forest Blvd
# 804
Jacksonville, FL 32244-5596

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120810000017 FL Part B Supplier - Clinic/Group Practice 3274789060 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1001828Reynaldo G Fermo Jr MD7855 Argyle Forest Boulevard, Suite 804, Jacksonville, FL 32244Certificate of waiverOct 5, 2027

National Provider Directory

National Provider Directory

Locations

7855 Argyle Forest Blvd
Ste 804
Jacksonville, FL 32244
Phone (904) 779-5870

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283126400000",
    "number": "1346556248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7855 ARGYLE FOREST BLVD",
            "address_2": "# 804",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7855 ARGYLE FOREST BLVD",
            "address_2": "# 804",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445596",
            "telephone_number": "904-421-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REYNALDO G FERMO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-30",
        "last_updated": "2010-08-30",
        "status": "A",
        "authorized_official_last_name": "FERMO",
        "authorized_official_first_name": "REYNALOD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-421-2119",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.