Organization Active NPI

My Physician Online

  • Medical Physician Assistant
  • Coral Springs, FL
National Provider Identifier
1770193500
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Legal business name
MY PHYSICIAN ONLINE
Practice address
9540 NW 23Rd St
Coral Springs, FL 33065-4974
Phone
(954) 778-8007
Fax
(949) 655-8591
NPI assigned
Aug 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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

Authorized official

Name
Ms. Tara Wiggins-Jones, PA
Title
Owner
Phone
(954) 778-8007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X Primary

Addresses

Primary practice location

9540 NW 23Rd St
Coral Springs, FL 33065-4974

Mailing address

9540 NW 23Rd St
Coral Springs, FL 33065-4974
Phone (954) 778-8007

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Kareo.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

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": "1596672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596672000000",
    "number": "1770193500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9540 NW 23RD ST",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654974",
            "telephone_number": "954-778-8007",
            "fax_number": "949-655-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9540 NW 23RD ST",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654974",
            "telephone_number": "954-778-8007",
            "fax_number": "949-655-8591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY PHYSICIAN ONLINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A",
        "authorized_official_last_name": "WIGGINS-JONES",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-778-8007",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Kareo.com",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "9540 NW 23rd St",
            "city": "Coral Springs",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330654974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; 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.