Organization Active NPI

William J Namen II DPM PA

  • Podiatrist
  • Jacksonville, FL
National Provider Identifier
1518012913
Registry record updated Mar 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
WILLIAM J NAMEN II DPM PA
Practice address
9310 Old Kings Rd S
Suite 1201
Jacksonville, FL 32257-6152
Phone
(904) 636-9197
Fax
(904) 636-9282
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2025

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

Authorized official

Name
William J Namen II, D.P.M., P.A.NPI 1063500692
Title
Owner
Phone
(904) 636-9197

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

9310 Old Kings Rd S
Suite 1201
Jacksonville, FL 32257-6152

Mailing address

9310 Old Kings Rd S
Suite 1201
Jacksonville, FL 32257-6152
Phone (904) 636-9197

Other identifiers 2

IdentifierTypeStateIssuer
390169601MedicaidFL
480026429OtherFLRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070205000449 FL Part B Supplier - Clinic/Group Practice 1951303999 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL; Jacksonville Beach, FL

National Provider Directory

National Provider Directory

Locations

580 W 8th St
Ste 502
Jacksonville, FL 32209
Phone (904) 353-1211

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742169600000",
    "number": "1518012913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9310 OLD KINGS RD S",
            "address_2": "SUITE 1201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322576152",
            "telephone_number": "904-636-9197",
            "fax_number": "904-636-9282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9310 OLD KINGS RD S",
            "address_2": "SUITE 1201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322576152",
            "telephone_number": "904-636-9197",
            "fax_number": "904-636-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM J NAMEN II DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A",
        "authorized_official_last_name": "NAMEN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-636-9197",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "D.P.M., P.A."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390169601",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "480026429",
            "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, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.