Individual provider Active NPI

Gary Joseph Battaglino, PHD

  • Psychologist
  • Jacksonville, FL
National Provider Identifier
1740520469
Registry record updated Feb 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
CPY0196020997 Issued in FL
Practice address
4040 Sunbeam Rd
Suite 2
Jacksonville, FL 32257-7547
Phone
(904) 619-8011
Fax
(904) 619-8011
NPI assigned
Feb 15, 2013
Last updated
Feb 15, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X CPY0196020997 FL Primary

Addresses

Primary practice location

4040 Sunbeam Rd
Suite 2
Jacksonville, FL 32257-7547

Mailing address

4040 Sunbeam Rd
Suite 2
Jacksonville, FL 32257-7547
Phone (904) 619-8011

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)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
CPY0196020997FLMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Solutions Counseling Past Accepting new patients
South Florida Counseling and Awareness Center Past Accepting new patients

Organizations & group practices 2

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": "1360886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1740520469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 SUNBEAM RD",
            "address_2": "SUITE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322577547",
            "telephone_number": "904-619-8011",
            "fax_number": "904-619-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 SUNBEAM RD",
            "address_2": "SUITE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322577547",
            "telephone_number": "904-619-8011",
            "fax_number": "904-619-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATTAGLINO",
        "first_name": "GARY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-15",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "CPY0196020997",
            "primary": true
        }
    ],
    "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 Feb 15, 2013; 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.