Beaches Behavioral Medicine

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

BEACHES BEHAVIORAL MEDICINE

Doing business as

Beaches Laser Spine and Pain Medicine
Beaches Specialty Group

Practice address

1351 13TH Ave S Ste 120
Jacksonville Beach, FL 32250-3237

Phone

(904) 280-6701

Fax

(904) 280-6702

NPI assigned

Jul 9, 2016

Last updated

Jan 12, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Justin Kuhns Spooner, MDNPI 1720269459

Title

President

Phone

(904) 280-6701

Specialties & licenses 8

Addresses

Other identifiers 1

Other names 2

• Beaches Laser Spine and Pain Medicine Doing business as
• Beaches Specialty Group Doing business as

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14032/brand/1/csg/1/fhir/r4

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.

• Justin Kuhns Spooner, MD

  • Child & Adolescent Psychiatry Physician
  • Ponte Vedra Beach, FL
  • NPI 1720269459
  Authorized official Same address or phone

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

{
    "created_epoch": "1468022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673481600000",
    "number": "1417309832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1557",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320041557",
            "telephone_number": "904-280-6701",
            "fax_number": "904-280-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 13TH AVE S STE 120",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503237",
            "telephone_number": "904-280-6701",
            "fax_number": "904-280-6702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2550 Park St",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "32204",
            "country_code": "US",
            "telephone_number": "904-280-6701",
            "fax_number": "904-280-6702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BEACHES BEHAVIORAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-09",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "SPOONER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "KUHNS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-280-6701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "FL",
            "license": "ME115625",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00863244100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaches Laser Spine and Pain Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beaches Specialty Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Ashley Bateh, PHARM.D.
• Paula Smith Bauer, MSW
• Mark Henry Baughman, PT ATC
• Beach Optical Company
• Beaches Acupuncture & Wellness Center
• Beaches Confident Kids LLC
• Beaches Counseling & Therapy
• Beaches Ear Nose & Throat
• Beaches Ear, Nose and Throat, PA
• Beaches Eye Center, PA

• Interventional Pain Medicine Physician in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Interventional Pain Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.