NPIMap

Organization Active NPI

Jacksonville Orthopaedic Institute Inc

  • Physical Therapist
  • Jacksonville, FL
National Provider Identifier
1467912063
Registry record updated Mar 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
JACKSONVILLE ORTHOPAEDIC INSTITUTE INC
Practice address
14534 Old Saint Augustine Rd Ste 3220
Jacksonville, FL 32258-2460
Phone
(904) 288-9491
Fax
(904) 288-9698
NPI assigned
Mar 21, 2019
Last updated
Mar 21, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2019

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

Authorized official

Name
Timothy Wall
Title
Director
Phone
(904) 346-3465

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

14534 Old Saint Augustine Rd Ste 3220
Jacksonville, FL 32258-2460

Mailing address

PO Box 117345
Atlanta, GA 30368-7345
Phone (904) 346-3465

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
10D2166849Jacksonville Orthopaedic Institute14534 Old St Augustine Rd Ste 3210, Jacksonville, FL 32258Certificate of waiverMay 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
Jacksonville Orth Inst27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553126400000",
    "number": "1467912063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 117345",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303687345",
            "telephone_number": "904-346-3465",
            "fax_number": "904-858-6489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14534 OLD SAINT AUGUSTINE RD STE 3220",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582460",
            "telephone_number": "904-288-9491",
            "fax_number": "904-288-9698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE ORTHOPAEDIC INSTITUTE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-21",
        "last_updated": "2019-03-21",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-346-3465"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Mar 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.