Jean-Claude Jeanty, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME0066990 Issued in FL

Practice address

1275 W Granada Blvd
Suite 3a
Ormond Beach, FL 32174-8259

Phone

(386) 672-1490

Fax

(386) 672-1682

NPI assigned

Nov 2, 2005

Last updated

Aug 3, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Coastal Pediatrics

  • Pediatrics Physician
  • Ormond Beach, FL
  • NPI 1780888321
  NPD (past) Authorized official
• Coastal Pediatrics LLC

  • Primary Care Clinic/Center
  • Ormond Beach, FL
  • NPI 1831199710
  NPD (past) Authorized official

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1427049105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 W GRANADA BLVD",
            "address_2": "SUITE 3A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748259",
            "telephone_number": "386-672-1490",
            "fax_number": "386-672-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 W GRANADA BLVD",
            "address_2": "SUITE 3A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321748259",
            "telephone_number": "386-672-1490",
            "fax_number": "386-672-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANTY",
        "first_name": "JEAN-CLAUDE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME0066990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE MEDICA",
            "identifier": "1202000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA HOSPITAL HEALTH",
            "identifier": "14019",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "759373",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "761792",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5907098",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6633914-001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "26333",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2672715900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jay a Keesling OD PA (20 20 Vision Center)
• Jay a Keesling OD PA (20 20 Vision Center)
• Jayne Kwiatkowski LLC (Tomoka Spine and Posture Institute)
• Jayne Kwiatkowski LLC
• Wenisha Jean
• Demeshanique Jefferson
• Jeffrey Demercurio MD PA (Florida Center for Plastic and Cosmetic Surgery)
• Jeffrey T Newfield DO PA (Newfield Orthopedics)
• Kimberly Deanne Jensen, LCSW
• Jerrold Ecklind DO PA

• Pediatrics Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; 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.