Active NPI
Jayden Ward
- Counselor
- Gulf Breeze, FL
National Provider Identifier
1619685658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- IMT3811
- Practice address
- 69 Bay Bridge Dr Unit H
Gulf Breeze, FL 32561-4468 - Phone
- (208) 819-3054
- NPI assigned
- Nov 8, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | IMT3811 | FL | Primary |
Addresses
Primary practice location
69 Bay Bridge Dr Unit H
Gulf Breeze, FL 32561-4468
Mailing address
10754 Crosscut Dr
Pensacola, FL 32506-9764
Phone (208) 819-3054
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMT3811 | FL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667865600000",
"number": "1619685658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10754 CROSSCUT DR",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325069764",
"telephone_number": "208-819-3054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "69 BAY BRIDGE DR UNIT H",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325614468",
"telephone_number": "208-819-3054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARD",
"first_name": "JAYDEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-08",
"last_updated": "2022-11-08",
"certification_date": "2022-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "IMT3811",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulf Breeze, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.