Active NPI
Jack Walter Lurton Jr., M.D.
- Otolaryngology Physician
- Pensacola, FL
National Provider Identifier
1497713747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- ME11915
- Practice address
- 14 W Jordan St
Pensacola, FL 32501-1736 - Phone
- (850) 436-4630
- Fax
- (850) 436-2095
- NPI assigned
- May 3, 2006
- 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 |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | ME11915 | FL | Primary |
Addresses
Primary practice location
14 W Jordan St
Pensacola, FL 32501-1736
Mailing address
14 W Jordan St
Pensacola, FL 32501-1736
Phone (850) 436-4630
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036679000 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME11915 | FL | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442188800000",
"number": "1497713747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 W JORDAN ST",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325011736",
"telephone_number": "850-436-4630",
"fax_number": "850-436-2095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 W JORDAN ST",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325011736",
"telephone_number": "850-436-4630",
"fax_number": "850-436-2095"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LURTON",
"first_name": "JACK",
"middle_name": "WALTER",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-03",
"last_updated": "2015-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "FL",
"license": "ME11915",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036679000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.