Atlantic Urological Associates P a

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

ATLANTIC UROLOGICAL ASSOCIATES P A

Practice address

545 Health Blvd
Daytona Beach, FL 32114-1493

Phone

(386) 239-8500

Fax

(386) 239-8530

NPI assigned

Apr 24, 2006

Organization subpart

No

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

Authorized official

Name

Jerri Creggar

Title

Chief Operating Officer

Phone

(386) 239-8500

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1145836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355356800000",
    "number": "1407812092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 HEALTH BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141493",
            "telephone_number": "386-239-8500",
            "fax_number": "386-239-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 HEALTH BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141493",
            "telephone_number": "386-239-8500",
            "fax_number": "386-239-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC UROLOGICAL ASSOCIATES P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-24",
        "last_updated": "2012-12-13",
        "status": "A",
        "authorized_official_last_name": "CREGGAR",
        "authorized_official_first_name": "JERRI",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "386-239-8500"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1900147",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037142400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "99107",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Atlantic Orthopaedics, PA
• Atlantic Podiatry Associates DPM PA
• Atlantic Snore and Sleep Apnea Center LLC
• Atlantic Surgery Center Inc
• Atlantic Urological Associates P a
• Atlantic Urological Associates P a
• Atlantic Urological Associates P a
• Atlas Academy, Inc
• Jocelynn Au, PA
• Earlyssia Austin

• Urology Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 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.