Organization Active NPI

Kartsonis Family Medicine, PLLC

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1457710733
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KARTSONIS FAMILY MEDICINE, PLLC
Practice address
6817 Southpoint Pkwy
Suite 1404
Jacksonville, FL 32216-6282
Phone
(904) 322-8844
NPI assigned
Feb 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Authorized official

Name
Philip D Kartsonis, M.D
Title
Family Physician
Phone
(904) 322-8844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6817 Southpoint Pkwy
Suite 1404
Jacksonville, FL 32216-6282

Mailing address

6817 Southpoint Parkway
Suite 1404
Jacksonville, FL 32216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160421000621 FL Part B Supplier - Clinic/Group Practice 8820396088 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2179234Kartsonis Family Medicine PLLC6817 Southpoint Pkwy - #1404, Jacksonville, FL 32216Certificate of waiverFeb 18, 2028

National Provider Directory

National Provider Directory

Locations

6817 Southpoint Pkwy
Ste 1404
Jacksonville, FL 32216
Phone (904) 260-1070

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464825600000",
    "number": "1457710733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PARKWAY",
            "address_2": "SUITE 1404",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY",
            "address_2": "SUITE 1404",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166282",
            "telephone_number": "904-322-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KARTSONIS FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-16",
        "last_updated": "2016-06-02",
        "status": "A",
        "authorized_official_last_name": "KARTSONIS",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "FAMILY PHYSICIAN",
        "authorized_official_telephone_number": "904-322-8844",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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 Jun 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.