Adesso Professional Services LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME130811 Issued in FL

Legal business name

ADESSO PROFESSIONAL SERVICES LLC

Practice address

1202 Kingsley Ave
Orange Park, FL 32073-4632

Phone

(877) 228-1221

Fax

(877) 842-4020

NPI assigned

Mar 14, 2018

Organization subpart

No

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

Authorized official

Name

Maria D Maynoldi, RN

Title

Administrator

Phone

(904) 579-4766

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• AMD PRIMARY CARE Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Maynoldi, M.D.

  • Hospitalist Physician
  • Orange Park, FL
  • NPI 1144591249

  Family Medicine, FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1520985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542067200000",
    "number": "1730682808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000-18 US HWY 17 S",
            "address_2": "# 241",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "32003",
            "telephone_number": "877-228-1221",
            "fax_number": "877-842-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734632",
            "telephone_number": "877-228-1221",
            "fax_number": "877-842-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADESSO PROFESSIONAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-14",
        "last_updated": "2018-11-13",
        "status": "A",
        "authorized_official_last_name": "MAYNOLDI",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-579-4766",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME130811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVID MAYNOLDI'S FL MED LIC",
            "identifier": "ME130811",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVID MAYNOLDI MD   NPI #",
            "identifier": "1144591249",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMD PRIMARY CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erica Chantal Adams, FNP
• Jessica Marie Adams, DO
• Jo Ann Adams, PT
• Melissa Pearle Adams, APRN
• Adelante Healthcare Services LLC
• Melanie Adkins
• Ashley Adkison
• Adorned by Ashley Hair Extensions
• Dawit Adugna, DDS
• Advanced Cardiac Diagnostics LLC

• All providers in Orange Park, FL
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; 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.