Active NPI
Willie McFadden Jr.
- Contractor
- Saint Johns, FL
National Provider Identifier
1497671291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 108 Morayshire CT
Saint Johns, FL 32259-6952 - Phone
- (904) 708-6339
- NPI assigned
- Jun 25, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Primary |
Addresses
Primary practice location
108 Morayshire CT
Saint Johns, FL 32259-6952
Mailing address
155 Bartram Market Dr Ste 109
Saint Johns, FL 32259-4582
Phone (904) 708-6339
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782345600000",
"number": "1497671291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 BARTRAM MARKET DR STE 109",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322594582",
"telephone_number": "904-708-6339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 MORAYSHIRE CT",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322596952",
"telephone_number": "904-708-6339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCFADDEN",
"first_name": "WILLIE",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-06-25",
"last_updated": "2026-06-25",
"certification_date": "2026-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Johns, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.