Individual provider Active NPI

William Ross Mayfield, M.D.

  • Interventional Pain Medicine Physician
  • Daytona Beach, FL
National Provider Identifier
1578627568
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
ME0063660 Issued in FL
Practice address
201 N Clyde Morris Blvd
Suite 120
Daytona Beach, FL 32114-2724
Phone
(386) 254-4029
Fax
(386) 254-4274
NPI assigned
Dec 21, 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
Interventional Pain Medicine Physician 208VP0014X ME0063660 FL Primary

Addresses

Primary practice location

201 N Clyde Morris Blvd
Suite 120
Daytona Beach, FL 32114-2724

Mailing address

201 N Clyde Morris Blvd
Suite 120
Daytona Beach, FL 32114-2724
Phone (386) 254-4029

Other identifiers 1

IdentifierTypeStateIssuer
18828OtherFLBLUE SHIELD

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
I20070111000181 FL Practitioner - Pain ManagementPractitioner - Interventional Pain ManagementPractitioner - Anesthesiology 2668472978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0063660FLMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Interventional Pain Service LLC Interventional Pain Medicine CurrentSince Jul 10, 2006 Accepting new patients
Volusia Anesthesia Associates Past Accepting new patients
Halifax Anesthesiology Associates PA PastSince May 15, 2013 Accepting new patients

Locations

201 N Clyde Morris Blvd
Ste 120
Daytona Beach, FL 32114
Phone (386) 254-4029

201 N Clyde Morris Blvd
Ste 230
Daytona Beach, FL 32114
Phone (386) 226-4537

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578627568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N CLYDE MORRIS BLVD",
            "address_2": "SUITE 120",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142724",
            "telephone_number": "386-254-4029",
            "fax_number": "386-254-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N CLYDE MORRIS BLVD",
            "address_2": "SUITE 120",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321142724",
            "telephone_number": "386-254-4029",
            "fax_number": "386-254-4274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYFIELD",
        "first_name": "WILLIAM",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "FL",
            "license": "ME0063660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "18828",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.