Active NPI
John Logan Felix, M.D.
- Family Medicine Physician
- Daytona Beach, FL
National Provider Identifier
1699815464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME96095
- Practice address
- 303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709 - Phone
- (386) 254-4165
- NPI assigned
- Feb 8, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME96095 | FL | Primary |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | ME 96095 | FL |
Addresses
Primary practice location
303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Mailing address
303 N Clyde Morris Blvd
Daytona Beach, FL 32114-2709
Phone (386) 254-4165
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 96095 | FL | MD | Sports Medicine (Family Medicine) Physician |
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318118400000",
"number": "1699815464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 N CLYDE MORRIS BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321142709",
"telephone_number": "386-254-4165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 N CLYDE MORRIS BLVD",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321142709",
"telephone_number": "386-254-4165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FELIX",
"first_name": "JOHN",
"middle_name": "LOGAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-08",
"last_updated": "2011-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME96095",
"primary": true
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "FL",
"license": "ME 96095",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.