Jade Marie Medders, EMT-B

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

EMT509305 Issued in FL

Practice address

725 Dunlawton Ave
#291938
Port Orange, FL 32129-7001

Phone

(386) 562-4070

Fax

(386) 492-6941

NPI assigned

Dec 11, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1750626172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 291938",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321291938",
            "telephone_number": "386-562-4070",
            "fax_number": "386-760-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 DUNLAWTON AVE",
            "address_2": "#291938",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321297001",
            "telephone_number": "386-562-4070",
            "fax_number": "386-492-6941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDDERS",
        "first_name": "JADE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "EMT-B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-11",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "FL",
            "license": "EMT509305",
            "primary": true
        },
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "DC",
            "license": "280101040340690",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline McMillian
• Abbey Elisabeth McMurray, PA
• Racquel McZeal
• Alexandra Meador
• Christina Mechtel
• Medfast Urgent Care Centers, LLC
• Medical & Psychiatric Insitiute of Florida, Inc.
• Arianna Medina
• Yvette Medina
• Megan Meeks

• Basic Emergency Medical Technician in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Basic Emergency Medical Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.