Ryan Cantville, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

OS12463 Issued in FL

Practice address

2606 Park St
Jacksonville, FL 32204-4520

Phone

(904) 388-4646

Fax

(904) 388-9017

NPI assigned

Apr 9, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ryan.cantville.1@8042.direct.athenahealth.com

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.

• Jacksonville Pediatrics World Golf Village PLLC

  • Primary Care Clinic/Center
  • St Augustine, FL
  • NPI 1275329823
  NPD Authorized official
• Privia Medical Group Florida, LLC

  • General Practice Physician
  • Indialantic, FL
  • NPI 1700649043
  NPD (past)

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

{
    "created_epoch": "1302307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1508156795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044520",
            "telephone_number": "904-388-4646",
            "fax_number": "904-388-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044520",
            "telephone_number": "904-388-4646",
            "fax_number": "904-388-9017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTVILLE",
        "first_name": "RYAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-09",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS12463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATELICENSE",
            "identifier": "OS 12463",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brett Bennett Cantrell, MD
• Laurel Duvall Cantrell, MD
• Michael Calvin Cantrell, MD
• Colby A Cantu, MD
• Adriana Cantville, D.O.
• Kaliyaha Cantwell
• Kioka Canty
• Trang M Cao, DMD
• Aaron Andrew Capera, PT
• Darren Capers Jr.

• Pediatrics Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.