Individual provider Active NPI

Matilda Townsend, D.P.M.

  • Podiatrist
  • Jacksonville, FL
National Provider Identifier
1710293428
Registry record updated Aug 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO 3443 Issued in FL
Practice address
2550 Park St
Jacksonville, FL 32204-4518
Phone
(904) 387-1403
NPI assigned
Aug 19, 2010
Last updated
Aug 19, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO 3443 FL Primary
Primary Podiatric Medicine Podiatrist 213EP1101X PO 3443 FL
Foot Surgery Podiatrist 213ES0131X PO 3443 FL

Addresses

Primary practice location

2550 Park St
Jacksonville, FL 32204-4518

Mailing address

2550 Park St
Jacksonville, FL 32204-4518
Phone (904) 387-1403

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

State licenses

LicenseStateTypeSpecialty
PO 3443FLMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1282176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282176000000",
    "number": "1710293428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044518",
            "telephone_number": "904-387-1403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 PARK ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044518",
            "telephone_number": "904-387-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOWNSEND",
        "first_name": "MATILDA",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-19",
        "last_updated": "2010-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO 3443",
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "FL",
            "license": "PO 3443",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO 3443",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 19, 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.