NPIMap

Individual provider Active NPI

Jia Li Duan, DO

  • Family Medicine Physician
  • Perry, FL
National Provider Identifier
1629647326
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS19571 Issued in FL
Practice address
555 N Byron Butler Pkwy
Perry, FL 32347-2315
Phone
(850) 838-8636
NPI assigned
Jun 18, 2021
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X OS19571 FL Primary

Addresses

Primary practice location

555 N Byron Butler Pkwy
Perry, FL 32347-2315

Mailing address

1301 Hodges Dr
Tallahassee, FL 32308-4614
Phone (850) 431-5430

Other practice location 1

1301 Hodges Dr
Tallahassee, FL 32308-4614
Phone (850) 431-5430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240715004359 FL Practitioner - Family Practice 8729471685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

555 N Byron Butler Pkwy
Perry, FL 32347-2315
Phone (850) 838-8636

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Memorial Healthcare Inc Family Medicine CurrentSince Jul 22, 2024 Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Tallahassee Memorial Healthcare Inc Current Accepting new patients
Tallahassee Memorial Healthcare Inc CurrentSince Jul 22, 2024 Accepting new patients

Locations

15 Council Moore Rd
Crawfordville, FL 32327
Phone (850) 926-7105

555 N Byron Butler Pkwy
Perry, FL 32347
Phone (850) 431-5360

1301 Hodges Dr
Tallahassee, FL 32308
Phone (850) 431-5430

1401 Centerville Rd
Ste 400
Tallahassee, FL 32308
Phone (850) 431-3360

1607 Saint James Ct
Ste 1
Tallahassee, FL 32308
Phone (850) 431-7021

Interoperability endpoints

  • Direct secure messaging: jialiduan@tmhpp.allscriptsdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1629647326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 HODGES DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084614",
            "telephone_number": "850-431-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N BYRON BUTLER PKWY",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323472315",
            "telephone_number": "850-838-8636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1301 Hodges Dr",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323084614",
            "country_code": "US",
            "telephone_number": "850-431-5430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUAN",
        "first_name": "JIA LI",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-18",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS19571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry, FL

Sources for this page

Verify at the official NPI Registry.