Individual provider Active NPI

David Craig Pearson, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Orange Park, FL
National Provider Identifier
1558322610
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
ME80556 Issued in FL
Practice address
1835 East West Parkway
Suite 19
Orange Park, FL 32003
Phone
(904) 215-7377
Fax
(904) 215-7350
NPI assigned
Mar 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X ME80556 FL Primary

Addresses

Primary practice location

1835 East West Parkway
Suite 19
Orange Park, FL 32003

Mailing address

1835 East West Parkway
Suite 19
Orange Park, FL 32003
Phone (904) 215-7377

Other identifiers 1

IdentifierTypeStateIssuer
268745300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041222000432 FL Practitioner - Otolaryngology 3577521665 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Virginia Commonwealth University, School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1835 Eastwest Pkwy
Suite 19
Fleming Island, FL 32003-5311
Phone (904) 215-7377

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME80556FLMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocare Express LLC CurrentSince Oct 20, 2024 Accepting new patients
Pearson Facial Plastic Surgery PA Otolaryngology/Facial Plastic Surgery CurrentSince Oct 1, 2004 Accepting new patients

Locations

1835 Eastwest Pkwy
Ste 19
Orange Park, FL 32003
Phone (507) 884-9439

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558322610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 EAST WEST PARKWAY",
            "address_2": "SUITE 19",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32003",
            "telephone_number": "904-215-7377",
            "fax_number": "904-215-7350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 EAST WEST PARKWAY",
            "address_2": "SUITE 19",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32003",
            "telephone_number": "904-215-7377",
            "fax_number": "904-215-7350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "DAVID",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "FL",
            "license": "ME80556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "268745300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.