Individual provider Active NPI

Elmarie Sabban, MD

  • Pediatrics Physician
  • Fernandina Beach, FL
National Provider Identifier
1639275860
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME79744 Issued in FL
Practice address
1463 Nectarine St
Fernandina Beach, FL 32034-3027
Phone
(904) 491-0177
Fax
(904) 491-3173
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME79744 FL Primary

Addresses

Primary practice location

1463 Nectarine St
Fernandina Beach, FL 32034-3027

Mailing address

86229 N Hampton Club Way
Fernandina Beach, FL 32034-8137
Phone (904) 225-9008

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME79744FLMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1639275860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86229 N HAMPTON CLUB WAY",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320348137",
            "telephone_number": "904-225-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 NECTARINE ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343027",
            "telephone_number": "904-491-0177",
            "fax_number": "904-491-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABBAN",
        "first_name": "ELMARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME79744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.