NPIMap

Organization Active NPI

Rta Health Care

Doing business as Injury Care Centers

  • General Practice Physician
  • Jacksonville, FL
National Provider Identifier
1477830453
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
1477830453 Issued in FL
Legal business name
RTA HEALTH CARE
Doing business as
Injury Care Centers
Practice address
5222 Lenox Ave
Jacksonville, FL 32205-4838
Phone
(904) 783-0008
NPI assigned
Nov 4, 2011
Last updated
Apr 16, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Authorized official

Name
Mrs. Adriana McClerren
Title
Administrator
Phone
(904) 994-4833

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 1477830453 FL Primary
Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364S00000X

Addresses

Primary practice location

5222 Lenox Ave
Jacksonville, FL 32205-4838

Mailing address

PO Box 49307
Jacksonville Beach, FL 32240-9307
Phone (904) 994-4833

Other names 1

  • Injury Care Centers Doing business as

National Provider Directory

National Provider Directory

Locations

5222 Lenox Ave
Jacksonville, FL 32205
Phone (904) 783-0008

Practitioners & affiliated clinicians

Practitioners 12

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": "1320364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366070400000",
    "number": "1477830453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49307",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322409307",
            "telephone_number": "904-994-4833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5222 LENOX AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322054838",
            "telephone_number": "904-783-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RTA HEALTH CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-04",
        "last_updated": "2013-04-16",
        "status": "A",
        "authorized_official_last_name": "MCCLERREN",
        "authorized_official_first_name": "ADRIANA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-994-4833",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "1477830453",
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Injury Care Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 16, 2013; 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.