Active NPI
My Physician Online
- Medical Physician Assistant
- Coral Springs, FL
National Provider Identifier
1770193500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Kareo.com | Health Information Exchange (HIE) |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physician Assistant
- Arlington, VA
- NPI 1356371611
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.