NPIMap

Organization Active NPI

First Coast Dermatology and Internal Medicine P a

  • Dermatology Physician
  • Jacksonville Beach, FL
National Provider Identifier
1518089846
Registry record updated Aug 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
FIRST COAST DERMATOLOGY AND INTERNAL MEDICINE P A
Practice address
3200 3Rd St S
Suite 200
Jacksonville Beach, FL 32250-6056
Phone
(904) 249-6110
Fax
(904) 249-6119
NPI assigned
Apr 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2017

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

Authorized official

Name
Dr. Alison O Moon, MDNPI 1740349950
Title
Director
Phone
(904) 249-6110

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
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

3200 3Rd St S
Suite 200
Jacksonville Beach, FL 32250-6056

Mailing address

3200 3Rd St S
Suite 200
Jacksonville Beach, FL 32250-6056
Phone (904) 249-6110

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503014400000",
    "number": "1518089846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 3RD ST S",
            "address_2": "SUITE 200",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506056",
            "telephone_number": "904-249-6110",
            "fax_number": "904-249-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 3RD ST S",
            "address_2": "SUITE 200",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506056",
            "telephone_number": "904-249-6110",
            "fax_number": "904-249-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST DERMATOLOGY AND INTERNAL MEDICINE P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2017-08-18",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "ALISON",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-249-6110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.