Organization Active NPI

Ronald E Bobus Acsw LMFT & Associates PA

  • Marriage & Family Therapist
  • Jacksonville Beach, FL
National Provider Identifier
1649437567
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT1194 Issued in FL
Legal business name
RONALD E BOBUS ACSW LMFT & ASSOCIATES PA
Practice address
3082 3Rd St S
Jacksonville Beach, FL 32250-6033
Phone
(904) 246-2629
Fax
(904) 246-1510
NPI assigned
May 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Authorized official

Name
Ronald E Bobus, ACSW LMFT
Title
PVST
Phone
(904) 246-2629

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X MT1194 FL Primary

Addresses

Primary practice location

3082 3Rd St S
Jacksonville Beach, FL 32250-6033

Mailing address

PO Box 1421
Ponte Vedra, FL 32004-1421
Phone (904) 246-2629

Other identifiers 6

IdentifierTypeStateIssuer
7471671OtherFLAETNA
136144193193OtherFLHUMANA
10745333OtherFLCAQH
734016000OtherFLMAGELLAN
Z2457OtherFLBLUE CROSS BLUE SHIELD
A059051OtherFLVALUE OPTIONS

National Provider Directory

National Provider Directory

Locations

3082 3rd St S
Jacksonville Beach, FL 32250
Phone (904) 246-2629

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": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1649437567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1421",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320041421",
            "telephone_number": "904-246-2629",
            "fax_number": "904-246-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3082 3RD ST S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506033",
            "telephone_number": "904-246-2629",
            "fax_number": "904-246-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RONALD E BOBUS ACSW LMFT & ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "BOBUS",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PVST",
        "authorized_official_telephone_number": "904-246-2629",
        "authorized_official_credential": "ACSW LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT1194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7471671",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "136144193193",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10745333",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "734016000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Z2457",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "A059051",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.