Organization Active NPI

Betty Anne Mincey MD PA

  • Internal Medicine Physician
  • Jacksonville Beach, FL
National Provider Identifier
1386766616
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME0071603 Issued in FL
Legal business name
BETTY ANNE MINCEY MD PA
Practice address
2370 3Rd St S
Suite 1
Jacksonville Beach, FL 32250-4023
Phone
(904) 241-8069
Fax
(904) 241-8071
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2012

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

Authorized official

Name
Dr. Betty Anne Mincey, M.D.
Title
Share Holder
Phone
(904) 241-8069

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME0071603 FL Primary

Addresses

Primary practice location

2370 3Rd St S
Suite 1
Jacksonville Beach, FL 32250-4023

Mailing address

2370 3Rd St S
Suite 1
Jacksonville Beach, FL 32250-4023
Phone (904) 241-8069

Other names 1

  • FIRSTCOAST INTERNAL MEDICINE PA Other name

National Provider Directory

National Provider Directory

Locations

572 Jacksonville Dr
Jax Bch, FL 32250
Phone (904) 222-6262

3200 3rd St S
Ste 200
Jax Bch, FL 32250
Phone (904) 249-6110

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336089600000",
    "number": "1386766616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 3RD ST S",
            "address_2": "SUITE 1",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322504023",
            "telephone_number": "904-241-8069",
            "fax_number": "904-241-8071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2370 3RD ST S",
            "address_2": "SUITE 1",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322504023",
            "telephone_number": "904-241-8069",
            "fax_number": "904-241-8071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETTY ANNE MINCEY MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2012-05-04",
        "status": "A",
        "authorized_official_last_name": "MINCEY",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "SHARE HOLDER",
        "authorized_official_telephone_number": "904-241-8069",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0071603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FIRSTCOAST INTERNAL MEDICINE PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2012; 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.