Individual provider Active NPI

Jason Brian Peace

  • Paramedic
  • Davie, FL
National Provider Identifier
1770341901
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ParamedicTaxonomy code 146L00000X
License
91480 Issued in OH
Practice address
13400 SW 14TH PL
Davie, FL 33325-5725
Phone
(859) 694-5418
NPI assigned
Mar 12, 2024
Last updated
Mar 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X NONE
Paramedic 146L00000X 91480 OH Primary

Addresses

Primary practice location

13400 SW 14TH PL
Davie, FL 33325-5725

Mailing address

13400 SW 14TH PL
Davie, FL 33325-5725
Phone (859) 694-5418

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

State licenses

LicenseStateTypeSpecialty
91480OHMDParamedic

NPI Registry JSON

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

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1770341901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 SW 14TH PL",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333255725",
            "telephone_number": "859-694-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 SW 14TH PL",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333255725",
            "telephone_number": "859-694-5418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEACE",
        "first_name": "JASON",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-12",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": "NONE",
            "primary": false
        },
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "OH",
            "license": "91480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.