Active NPI
James Timothy Damiani, M.D.
- Psychiatry Physician
- Macclenny, FL
National Provider Identifier
1376650069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- ME 54384
- Practice address
- 7487 S State Road 121
Macclenny, FL 32063-5451 - Phone
- (990) 425-9621
- Fax
- (904) 259-7104
- NPI assigned
- Aug 25, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME 54384 | FL | Primary |
Addresses
Primary practice location
7487 S State Road 121
Macclenny, FL 32063-5451
Mailing address
7487 S State Road 121
Macclenny, FL 32063-5451
Phone (990) 425-9621
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 54384 | FL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376650069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7487 S STATE ROAD 121",
"city": "MACCLENNY",
"state": "FL",
"postal_code": "320635451",
"telephone_number": "990-425-9621",
"fax_number": "904-259-7104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7487 S STATE ROAD 121",
"city": "MACCLENNY",
"state": "FL",
"postal_code": "320635451",
"telephone_number": "990-425-9621",
"fax_number": "904-259-7104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAMIANI",
"first_name": "JAMES",
"middle_name": "TIMOTHY",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME 54384",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macclenny, 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.