Active NPI
John P. Mahoney, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Tallahassee, FL
National Provider Identifier
1366413668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- ME25794
- Practice address
- 1899 Eider CT
Tallahassee, FL 32308-4537 - Phone
- (850) 878-5143
- Fax
- (850) 942-6622
- NPI assigned
- Jan 27, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | ME25794 | FL | Primary |
Addresses
Primary practice location
1899 Eider CT
Tallahassee, FL 32308-4537
Mailing address
1899 Eider CT
Tallahassee, FL 32308-4537
Phone (850) 878-5143
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0442313 | Medicaid | FL | |
| 220006547 | Other | FL | RAILROAD MEDICARE |
| 37414 | Other | FL | BCBS INDIVIDUAL PROVIDER# |
| ME25794 | Other | FL | FL MEDICAL EXAMINER LICEN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25794 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200528000000",
"number": "1366413668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1899 EIDER CT",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323084537",
"telephone_number": "850-878-5143",
"fax_number": "850-942-6622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1899 EIDER CT",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323084537",
"telephone_number": "850-878-5143",
"fax_number": "850-942-6622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHONEY",
"first_name": "JOHN",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-27",
"last_updated": "2008-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "FL",
"license": "ME25794",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0442313",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "220006547",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS INDIVIDUAL PROVIDER#",
"identifier": "37414",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FL MEDICAL EXAMINER LICEN",
"identifier": "ME25794",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.