Active NPI
Aisha Kavumkal, MD
- Public Health & General Preventive Medicine Physician
- Jacksonville, FL
National Provider Identifier
1447878558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- ME162925
- Practice address
- 1536 N Jefferson St
Jacksonville, FL 32209-6525 - Phone
- (813) 707-4266
- NPI assigned
- Jul 6, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | ME162925 | FL | Primary |
Addresses
Primary practice location
1536 N Jefferson St
Jacksonville, FL 32209-6525
Mailing address
2614 Valencia Grove Dr
Valrico, FL 33596-5953
Phone (813) 707-4266
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200708003486 | MI | Order and Referring Only - General Practice | 5496178436 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME162925 | FL | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695081600000",
"number": "1447878558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2614 VALENCIA GROVE DR",
"city": "VALRICO",
"state": "FL",
"postal_code": "335965953",
"telephone_number": "813-707-4266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1536 N JEFFERSON ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322096525",
"telephone_number": "813-707-4266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAVUMKAL",
"first_name": "AISHA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-06",
"last_updated": "2023-09-19",
"certification_date": "2023-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "FL",
"license": "ME162925",
"primary": true
}
],
"identifiers": [],
"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 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.