Active NPI
Lewis J Obi, MD
- Specialist
- Jacksonville, FL
National Provider Identifier
1356404792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- ME0012407
- Practice address
- 3599 University Blvd S
#604
Jacksonville, FL 32216-4252 - Phone
- (904) 399-0905
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | ME0012407 | Primary |
Addresses
Primary practice location
3599 University Blvd S
#604
Jacksonville, FL 32216-4252
Mailing address
3599 University Blvd S
#604
Jacksonville, FL 32216-4252
Phone (904) 399-0905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100415000682 | FL | Practitioner - Plastic and Reconstructive Surgery | 1456488832 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1356404792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3599 UNIVERSITY BLVD S",
"address_2": "#604",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322164252",
"telephone_number": "904-399-0905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3599 UNIVERSITY BLVD S",
"address_2": "#604",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322164252",
"telephone_number": "904-399-0905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OBI",
"first_name": "LEWIS",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": "ME0012407",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.