Individual provider Active NPI

Orlando Villlanueva Rendon, M.D.

  • Pediatrics Physician
  • Jacksonville, FL
National Provider Identifier
1700891595
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME72080 Issued in FL
Practice address
8351 Westport Rd
Jacksonville, FL 32244-5901
Phone
(904) 317-8811
Fax
(904) 317-4949
NPI assigned
Jul 30, 2006
Last updated
Aug 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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 ME72080 FL Primary

Addresses

Primary practice location

8351 Westport Rd
Jacksonville, FL 32244-5901

Mailing address

8351 Westport Rd
Jacksonville, FL 32244-5901
Phone (904) 317-8811

Other identifiers 3

IdentifierTypeStateIssuer
255283300MedicaidFL
277899800MedicaidFL
277899801MedicaidFL

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Associates at Argyle PA Pediatrics Past Accepting new patients
Pediatric Associates at Argyle PA Pediatrics PastSince Aug 27, 2023 Accepting new patients
Starke Hma Medical Group LLC Pediatrics Past Accepting new patients
Shands Teaching Hospital and Clinics Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pediatricassociatesatargylepa.orlandorendon@112627.advancedmd-direct.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1700891595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8351 WESTPORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445901",
            "telephone_number": "904-317-8811",
            "fax_number": "904-317-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8351 WESTPORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322445901",
            "telephone_number": "904-317-8811",
            "fax_number": "904-317-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENDON",
        "first_name": "ORLANDO",
        "middle_name": "VILLLANUEVA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME72080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "255283300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277899800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277899801",
            "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 Aug 12, 2016; 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.