Organization Active NPI

Jack M. Matheny II, MD

  • Family Medicine Physician
  • Palatka, FL
National Provider Identifier
1629198544
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JACK M. MATHENY II, MD
Practice address
700 Zeagler Dr Ste 10
Palatka, FL 32177-3826
Phone
(386) 328-6746
Fax
(386) 328-7554
NPI assigned
Apr 2, 2007
Organization subpart
Yes
Parent organization
JACK M MATHENY II MDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Satish Ravi, MD
Title
Authorized Official
Phone
(386) 328-6746

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

700 Zeagler Dr Ste 10
Palatka, FL 32177-3826

Mailing address

700 Zeagler Dr Ste 10
Palatka, FL 32177-3826
Phone (386) 328-6746

Other names 1

  • JACK M. MATHENY II, MD, RHC Other name

National Provider Directory

National Provider Directory
Part of
Jack Matheny II MD

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1629198544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ZEAGLER DR STE 10",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773826",
            "telephone_number": "386-328-6746",
            "fax_number": "386-328-7554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 ZEAGLER DR STE 10",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773826",
            "telephone_number": "386-328-6746",
            "fax_number": "386-328-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK M. MATHENY II, MD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JACK M MATHENY II MD",
        "enumeration_date": "2007-04-02",
        "last_updated": "2025-09-02",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "RAVI",
        "authorized_official_first_name": "SATISH",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "386-328-6746",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JACK M. MATHENY II, MD, RHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Palatka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.