Active NPI
Reginald L Sykes, MD
- Family Medicine Physician
- Jacksonville, FL
National Provider Identifier
1790730661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME58350
- Practice address
- 3160 Edgewood Ave
Jacksonville, FL 32209-2245 - Phone
- (904) 768-8222
- Fax
- (904) 482-0373
- NPI assigned
- May 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME0058350 | FL | |
| Family Medicine Physician | 207Q00000X | ME58350 | FL | Primary |
Addresses
Primary practice location
3160 Edgewood Ave
Jacksonville, FL 32209-2245
Mailing address
PO Box 61148
Jacksonville, FL 32236-1148
Phone (904) 400-6100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 064400500 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME0058350 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263427200000",
"number": "1790730661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 61148",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322361148",
"telephone_number": "904-400-6100",
"fax_number": "904-400-6102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3160 EDGEWOOD AVE",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322092245",
"telephone_number": "904-768-8222",
"fax_number": "904-482-0373"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYKES",
"first_name": "REGINALD",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-22",
"last_updated": "2010-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME0058350",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME58350",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "064400500",
"state": "FL"
}
],
"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 Jan 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.