Active NPI
Independent Pediatricians of North FL Inc
- Legal Medicine
- Jacksonville, FL
National Provider Identifier
1386723005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine
- License
- ME56953
- Legal business name
- INDEPENDENT PEDIATRICIANS OF NORTH FL INC
- Practice address
- 4051 Atlantic Blvd
Jacksonville, FL 32207-2036 - Phone
- (904) 493-9702
- Fax
- (904) 493-9700
- NPI assigned
- Nov 3, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Paulette L Tressler, ADMINISTRATOR
- Title
- Administrator
- Phone
- (904) 493-9702
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine | 173000000X | ME56953 | FL | Primary |
Addresses
Primary practice location
4051 Atlantic Blvd
Jacksonville, FL 32207-2036
Mailing address
4051 Atlantic Blvd
Jacksonville, FL 32207-2036
Phone (904) 493-9702
Other identifiers 30
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 271318700 | Medicaid | FL | |
| 273107000 | Medicaid | FL | |
| 277263903 | Medicaid | FL | |
| 042374200 | Medicaid | FL | |
| 273661600 | Medicaid | FL | |
| ME92233 | Other | FL | ME LICENSE |
| 055661101 | Medicaid | FL | |
| ME57974 | Other | FL | ME LICENSE |
| 260365900 | Medicaid | FL | |
| 277393700 | Medicaid | FL | |
| ARNP3253072 | Other | FL | LICENSE |
| ME100160 | Other | FL | ME LICENSE |
| ME44431 | Other | FL | ME LICENSE |
| 277263900 | Medicaid | FL | |
| ME32409 | Other | FL | ME LICENSE |
| ME56953 | Other | FL | ME LICENSE |
| ME63783 | Other | FL | ME LICENSE |
| ME91195 | Other | FL | ME LICENSE |
| 277263904 | Medicaid | FL | |
| 277263905 | Medicaid | FL | |
| 306870600 | Medicaid | FL | |
| ARNP9180604 | Other | FL | LICENSE |
| ME38917 | Other | FL | ME LICENSE |
| ME55120 | Other | FL | ME LICENSE |
| ME6612 | Other | FL | ME LICENSE |
| 066208900 | Medicaid | FL | |
| 1285741348 | Other | FL | O'RIELLY MD PA |
| 277263901 | Medicaid | FL | |
| 277263902 | Medicaid | FL | |
| ME62891 | Other | FL | ME LICENSE |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1220832000000",
"number": "1386723005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4051 ATLANTIC BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322072036",
"telephone_number": "904-493-9702",
"fax_number": "904-493-9700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4051 ATLANTIC BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322072036",
"telephone_number": "904-493-9702",
"fax_number": "904-493-9700"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INDEPENDENT PEDIATRICIANS OF NORTH FL INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-03",
"last_updated": "2008-09-08",
"status": "A",
"authorized_official_last_name": "TRESSLER",
"authorized_official_first_name": "PAULETTE",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "904-493-9702",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "ADMINISTRATOR"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Legal Medicine",
"state": "FL",
"license": "ME56953",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "271318700",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "273107000",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "277263903",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "042374200",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "273661600",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ME LICENSE",
"identifier": "ME92233",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "055661101",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ME LICENSE",
"identifier": "ME57974",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "260365900",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "277393700",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "ARNP3253072",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ME LICENSE",
"identifier": "ME100160",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ME LICENSE",
"identifier": "ME44431",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "277263900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ME LICENSE",
"identifier": "ME32409",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ME LICENSE",
"identifier": "ME56953",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ME LICENSE",
"identifier": "ME63783",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ME LICENSE",
"identifier": "ME91195",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "277263904",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "277263905",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "306870600",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "ARNP9180604",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ME LICENSE",
"identifier": "ME38917",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ME LICENSE",
"identifier": "ME55120",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ME LICENSE",
"identifier": "ME6612",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "066208900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "O'RIELLY MD PA",
"identifier": "1285741348",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "277263901",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "277263902",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ME LICENSE",
"identifier": "ME62891",
"state": "FL"
}
],
"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 Sep 8, 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.