Organization Active NPI

Joan M McNeela

  • Podiatrist
  • Titusville, FL
National Provider Identifier
1720451446
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO1457 Issued in FL
Legal business name
JOAN M MCNEELA
Practice address
1717 Garden St
Titusville, FL 32796-5002
Phone
(321) 267-5577
Fax
(321) 264-0724
NPI assigned
Nov 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Authorized official

Name
Joan M McNeela, DPM
Title
Podiatrist/Owner
Phone
(321) 267-5577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X PO1457 FL Primary

Addresses

Primary practice location

1717 Garden St
Titusville, FL 32796-5002

Mailing address

1717 Garden St
Titusville, FL 32796-5002
Phone (321) 267-5577

Other identifiers 2

IdentifierTypeStateIssuer
1720451446OtherFLGROUP NPI
4EDHKOtherFLFLORIDA BLUE INDENTIFICATION NUMBER FOR GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160307000699 FL Part B Supplier - Clinic/Group Practice 2062718752 Receives reassigned benefits from 1 practitioner
Practice locations: Titusville, FL

National Provider Directory

National Provider Directory

Locations

1717 Garden St
Titusville, FL 32796
Phone (321) 267-5577

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": "1446508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464134400000",
    "number": "1720451446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327965002",
            "telephone_number": "321-267-5577",
            "fax_number": "321-264-0724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 GARDEN ST",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327965002",
            "telephone_number": "321-267-5577",
            "fax_number": "321-264-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOAN M MCNEELA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-03",
        "last_updated": "2016-05-25",
        "status": "A",
        "authorized_official_last_name": "MCNEELA",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PODIATRIST/OWNER",
        "authorized_official_telephone_number": "321-267-5577",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO1457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1720451446",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE INDENTIFICATION NUMBER FOR GROUP",
            "identifier": "4EDHK",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.