Individual provider Active NPI

John Hale, PA

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1447229760
Registry record updated Sep 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9102043 Issued in FL
Practice address
5191 First Coast Tech Pkwy
3Rd Floor
Jacksonville, FL 32224-0609
Phone
(904) 223-3321
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X G247922842 GA
Physician Assistant 363A00000X PA9102043 FL Primary

Addresses

Primary practice location

5191 First Coast Tech Pkwy
3Rd Floor
Jacksonville, FL 32224-0609

Mailing address

5191 First Coast Tech Pkwy
3Rd Floor
Jacksonville, FL 32224-0609
Phone (904) 223-3321

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jhale391106@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040512001472 FL Practitioner - Physician Assistant 7719977883 Reassigns benefits to 3 organizations
I20210312000737 GA Practitioner - Physician Assistant 7719977883

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Jacksonville Spine Center PAGroup PAC ID 6901890300, 38 clinicians
Lake Area Physical Therapy Inc.Group PAC ID 3678604840, 372 clinicians

Practice addresses (Care Compare)

1100 Plantation Island Dr S
Suite 220
St Augustine, FL 32080-5174
Phone (904) 223-3321

1351 13TH Ave S
Suite 120
Jacksonville Beach, FL 32250-3237
Phone (904) 223-3321

5191 1St Coast Tech Pkwy
FL 3
Jacksonville, FL 32224-0609
Phone (904) 223-3321

PO Box
Melrose, FL 32666-1099

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9102043FLMDPhysician Assistant
G247922842GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville CurrentSince Jun 20, 2016 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Jun 20, 2016 Accepting new patients
Jacksonville Spine Center PA CurrentSince Nov 13, 2013 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Oct 27, 2008 Accepting new patients
Jacksonville Spine Center PA CurrentSince Nov 13, 2013 Accepting new patients
Marshall Amaya & Anton P L Physician Assistant Past Accepting new patients

Locations

2349 Village Square Pkwy
Ste 107
Fleming Island, FL 32003
Phone (904) 257-0060

10475 Centurion Pkwy N
Ste 201
Jacksonville, FL 32256
Phone 90422333213118

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

5191 First Coast Tech Pkwy
Fl 3
Jacksonville, FL 32224
Phone (904) 222-3332

1100 Plantation Island Dr S
Ste 220
Saint Augustine, FL 32080
Phone (904) 436-6420

Interoperability endpoints

  • Direct secure messaging: john.hale@jspc.eclinicaldirectplus.com

Organizations & group practices 7

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1447229760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5191 FIRST COAST TECH PKWY",
            "address_2": "3RD FLOOR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240609",
            "telephone_number": "904-223-3321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5191 FIRST COAST TECH PKWY",
            "address_2": "3RD FLOOR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240609",
            "telephone_number": "904-223-3321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALE",
        "first_name": "JOHN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "G247922842",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhale391106@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "4500 San Pablo Rd S",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322241865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.