Organization Active NPI

Kongnyuy Urology PLLC

Doing business as St Johns Urology

  • Urology Physician
  • Jacksonville, FL
National Provider Identifier
1366243891
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
KONGNYUY UROLOGY PLLC
Doing business as
St Johns Urology
Practice address
2232 College St Apt 3
Jacksonville, FL 32204-3123
Phone
(904) 323-1484
Fax
(216) 208-1524
NPI assigned
Mar 21, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Authorized official

Name
Michael Kongnyuy, MDNPI 1952833006
Title
President
Phone
(608) 738-8867

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

2232 College St Apt 3
Jacksonville, FL 32204-3123

Mailing address

2232 College St Apt 3
Jacksonville, FL 32204-3123

Other names 1

  • St Johns Urology Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1742515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742515200000",
    "number": "1366243891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 COLLEGE ST APT 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 COLLEGE ST APT 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043123",
            "telephone_number": "904-323-1484",
            "fax_number": "216-208-1524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KONGNYUY UROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-21",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A",
        "authorized_official_last_name": "KONGNYUY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "608-738-8867",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Johns Urology",
            "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 Mar 21, 2025; 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.