Active NPI
Olan T. McFerrin, PA
- Physician Assistant
- Jacksonville, FL
National Provider Identifier
1699790675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA1543
- Practice address
- 11513 N Main St
Jacksonville, FL 32218-4002 - Phone
- (904) 751-6200
- Fax
- (904) 751-1600
- NPI assigned
- Jul 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA1543 | FL | Primary |
Addresses
Primary practice location
11513 N Main St
Jacksonville, FL 32218-4002
Mailing address
11513 N Main St
Jacksonville, FL 32218-4002
Phone (904) 751-6200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 290613900 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA1543 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oceanway Medical Center, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Jacksonville, FL
- NPI 1245255199
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399852800000",
"number": "1699790675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11513 N MAIN ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322184002",
"telephone_number": "904-751-6200",
"fax_number": "904-751-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11513 N MAIN ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322184002",
"telephone_number": "904-751-6200",
"fax_number": "904-751-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCFERRIN",
"first_name": "OLAN",
"middle_name": "T.",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2014-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA1543",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "290613900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.