NPIMap

Organization Active NPI

Jayalakshmi Padmanabhan MD, PA

  • Cardiovascular Disease Physician
  • Orange Park, FL
National Provider Identifier
1639388069
Registry record updated Mar 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
JAYALAKSHMI PADMANABHAN MD, PA
Practice address
108 Kingsley Ave
Orange Park, FL 32073-5685
Phone
(904) 264-0000
NPI assigned
May 22, 2007
Last updated
Mar 8, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2010

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

Authorized official

Name
Jayalakshmi Padmanabhan, M.D., P.A.NPI 1386645778
Title
President
Phone
(904) 264-0000

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
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

108 Kingsley Ave
Orange Park, FL 32073-5685

Mailing address

108 Kingsley Ave
Orange Park, FL 32073-5685
Phone (904) 264-0000

Other identifiers 1

IdentifierTypeStateIssuer
264175500MedicaidFL

National Provider Directory

National Provider Directory

Locations

108 Kingsley Ave
Orange Park, FL 32073
Phone (904) 264-0000

Practitioners & affiliated clinicians

Practitioners 6

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": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268006400000",
    "number": "1639388069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735685",
            "telephone_number": "904-264-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735685",
            "telephone_number": "904-264-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYALAKSHMI PADMANABHAN MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2010-03-08",
        "status": "A",
        "authorized_official_last_name": "PADMANABHAN",
        "authorized_official_first_name": "JAYALAKSHMI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-264-0000",
        "authorized_official_credential": "M.D., P.A."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264175500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; 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.