NPIMap

Organization Active NPI

Dr. Mary Soha, M.D.,Inc.

Doing business as Dr. Mary's Place

  • Pediatrics Physician
  • Jacksonville, FL
National Provider Identifier
1578792032
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME56953 Issued in FL
Legal business name
DR. MARY SOHA, M.D.,INC.
Doing business as
Dr. Mary's Place
Practice address
4051 Atlantic Blvd
Jacksonville, FL 32207-2036
Phone
(904) 393-4700
Fax
(904) 493-9700
NPI assigned
Jul 6, 2009
Last updated
Jul 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

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

Authorized official

Name
Dr. Mary E Soha, M.D.NPI 1639282791
Title
President
Phone
(904) 393-4700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME56953 FL Primary

Addresses

Primary practice location

4051 Atlantic Blvd
Jacksonville, FL 32207-2036

Mailing address

4051 Atlantic Blvd
Jacksonville, FL 32207-2036
Phone (904) 393-4700

Other identifiers 1

IdentifierTypeStateIssuer
055661101MedicaidFL

Other names 1

  • Dr. Mary's Place Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1246838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246838400000",
    "number": "1578792032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4051 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072036",
            "telephone_number": "904-393-4700",
            "fax_number": "904-493-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072036",
            "telephone_number": "904-393-4700",
            "fax_number": "904-493-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MARY SOHA, M.D.,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-06",
        "last_updated": "2009-07-06",
        "status": "A",
        "authorized_official_last_name": "SOHA",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-393-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME56953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055661101",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Mary's Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 6, 2009; 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.