Active NPI
Jamie T Surratt, MD
- Diagnostic Radiology Physician
- Jacksonville, FL
National Provider Identifier
1497715312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- ME62463
- Practice address
- 3599 University Blvd S
Building 300
Jacksonville, FL 32216-4252 - Phone
- (904) 399-5550
- Fax
- (904) 346-4334
- NPI assigned
- Mar 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | ME62463 | FL | |
| Neuroradiology Physician | 2085N0700X | ME62463 | FL | |
| Nuclear Radiology Physician | 2085N0904X | ME62463 | FL | |
| Pediatric Radiology Physician | 2085P0229X | ME62463 | FL | |
| Diagnostic Radiology Physician | 2085R0202X | ME62463 | FL | Primary |
| Vascular & Interventional Radiology Physician | 2085R0204X | ME62463 | FL | |
| Diagnostic Ultrasound Physician | 2085U0001X | ME62463 | FL |
Addresses
Primary practice location
3599 University Blvd S
Building 300
Jacksonville, FL 32216-4252
Mailing address
3599 University Blvd S
Building 300
Jacksonville, FL 32216-4252
Phone (904) 399-5550
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00529867B | Medicaid | GA | |
| 18063 | Other | FL | BCBS |
| 370978700 | 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 |
|---|---|---|---|
| ME62463 | FL | MD | Vascular & Interventional Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Imaging Services of Jacksonville LLC | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Diagnostic Radiology Physician
- Jacksonville, FL
- NPI 1154586964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268784000000",
"number": "1497715312",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3599 UNIVERSITY BLVD S",
"address_2": "BUILDING 300",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322164252",
"telephone_number": "904-399-5550",
"fax_number": "904-346-4334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3599 UNIVERSITY BLVD S",
"address_2": "BUILDING 300",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322164252",
"telephone_number": "904-399-5550",
"fax_number": "904-346-4334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SURRATT",
"first_name": "JAMIE",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-24",
"last_updated": "2010-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "FL",
"license": "ME62463",
"primary": false
},
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "FL",
"license": "ME62463",
"primary": false
},
{
"code": "2085N0904X",
"taxonomy_group": "",
"desc": "Radiology, Nuclear Radiology",
"state": "FL",
"license": "ME62463",
"primary": false
},
{
"code": "2085P0229X",
"taxonomy_group": "",
"desc": "Radiology, Pediatric Radiology",
"state": "FL",
"license": "ME62463",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "FL",
"license": "ME62463",
"primary": true
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "FL",
"license": "ME62463",
"primary": false
},
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "FL",
"license": "ME62463",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00529867B",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "18063",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "370978700",
"state": "FL"
}
],
"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 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.