Organization Active NPI

Gregory J Sengstock MD PA

  • Specialist
  • Jacksonville, FL
National Provider Identifier
1396887832
Registry record updated Sep 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME81447 Issued in FL
Legal business name
GREGORY J SENGSTOCK MD PA
Practice address
14546 Saint Augustine Rd
Suite 301
Jacksonville, FL 32258-5468
Phone
(904) 292-4049
Fax
(904) 292-4805
NPI assigned
Feb 13, 2007
Last updated
Sep 18, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2012

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

Authorized official

Name
Dr. Gregory Sengstock, MD,PHDNPI 1033179858
Title
Physician
Phone
(904) 292-4049

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME81447 FL Primary

Addresses

Primary practice location

14546 Saint Augustine Rd
Suite 301
Jacksonville, FL 32258-5468

Mailing address

14546 Old Saint Augustine Rd
Ste 301
Jacksonville, FL 32258-5468
Phone (904) 292-4049

Other identifiers 1

IdentifierTypeStateIssuer
1033179858OtherFLNPI

National Provider Directory

National Provider Directory

Locations

1340 S 18th St
Ste 203
Fernandina Beach, FL 32034
Phone (904) 261-7707

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347926400000",
    "number": "1396887832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14546 OLD SAINT AUGUSTINE RD",
            "address_2": "STE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585468",
            "telephone_number": "904-292-4049",
            "fax_number": "904-292-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14546 SAINT AUGUSTINE RD",
            "address_2": "SUITE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585468",
            "telephone_number": "904-292-4049",
            "fax_number": "904-292-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY J SENGSTOCK MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2012-09-18",
        "status": "A",
        "authorized_official_last_name": "SENGSTOCK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "904-292-4049",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD,PHD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME81447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1033179858",
            "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 18, 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.