Organization Active NPI

North Florida Amputation Prevention Center, LLC

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Orange Park, FL
National Provider Identifier
1558677351
Registry record updated Nov 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianTaxonomy code 207PE0005X
Legal business name
NORTH FLORIDA AMPUTATION PREVENTION CENTER, LLC
Practice address
2140 Kingsley Ave Ste 9
Orange Park, FL 32073-5129
Phone
(904) 375-2070
Fax
(904) 375-2075
NPI assigned
Aug 31, 2010
Last updated
Nov 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2012

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

Authorized official

Name
Dr. Jorg A. Bober, M.D.NPI 1720108012
Title
Partner
Phone
(904) 375-2070

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
Undersea and Hyperbaric Medicine (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PE0005X Primary

Addresses

Primary practice location

2140 Kingsley Ave Ste 9
Orange Park, FL 32073-5129

Mailing address

2140 Kingsley Ave Ste 9
Orange Park, FL 32073-5129
Phone (904) 375-2070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101110000284 FL Part B Supplier - Clinic/Group Practice 4284829771 Receives reassigned benefits from 1 practitioner
Practice locations: Orange Park, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1283212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1558677351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 KINGSLEY AVE STE 9",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735129",
            "telephone_number": "904-375-2070",
            "fax_number": "904-375-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 KINGSLEY AVE STE 9",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735129",
            "telephone_number": "904-375-2070",
            "fax_number": "904-375-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FLORIDA AMPUTATION PREVENTION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-31",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "BOBER",
        "authorized_official_first_name": "JORG",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "904-375-2070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207PE0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.