John L Gaines Jr MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME38167 Issued in FL

Legal business name

JOHN L GAINES JR MD PA

Practice address

530 Zeagler Dr
Ste a
Palatka, FL 32177-6855

Phone

(386) 328-8358

Fax

(386) 325-0635

NPI assigned

Nov 15, 2006

Last updated

May 29, 2008By 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

John L Gaines Jr., MDNPI 1508847021

Title

President

Phone

(386) 328-8358

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• John L Gaines Jr MD Other name

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.

• John L Gaines Jr., MD

  • Internal Medicine Physician
  • Palatka, FL
  • NPI 1508847021
  Authorized official Same address or phone

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1467524298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 ZEAGLER DR",
            "address_2": "STE A",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321776855",
            "telephone_number": "386-328-8358",
            "fax_number": "386-325-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 ZEAGLER DR",
            "address_2": "STE A",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321776855",
            "telephone_number": "386-328-8358",
            "fax_number": "386-325-0635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN L GAINES JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "GAINES",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-328-8358",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME38167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "54048",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065427200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110158966",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIV NPI",
            "identifier": "1508847021",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John L Gaines Jr MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Internal Medicine Physician in Palatka, FL
• Providers in Palatka, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.