NPIMap

Organization Active NPI

Memorial Family Practice Associates

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1477613172
Registry record updated Jul 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEMORIAL FAMILY PRACTICE ASSOCIATES
Practice address
3546 St Johns Bluff Road South
Suite 108
Jacksonville, FL 32224
Phone
(904) 306-8067
NPI assigned
Dec 11, 2006
Last updated
Jul 26, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2007

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

Authorized official

Name
Paula Buckingham
Title
Administrator
Phone
(904) 306-8067

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3546 St Johns Bluff Road South
Suite 108
Jacksonville, FL 32224

Mailing address

PO Box 277272
Atlanta, GA 30384-7272

National Provider Directory

National Provider Directory
Tax ID family
Memorial Family Practice LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185408000000",
    "number": "1477613172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277272",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3546 ST JOHNS BLUFF ROAD SOUTH",
            "address_2": "SUITE 108",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32224",
            "telephone_number": "904-306-8067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL FAMILY PRACTICE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-26",
        "status": "A",
        "authorized_official_last_name": "BUCKINGHAM",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-306-8067"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-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 Jul 26, 2007; 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.