Active NPI
David E Pirrung, M.D.
- Family Medicine Physician
- Jacksonville, FL
National Provider Identifier
1811930589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME11514
- Practice address
- 4495 Roosevelt Blvd
Suite 316
Jacksonville, FL 32210-3375 - Phone
- (904) 384-5222
- Fax
- (904) 384-6468
- NPI assigned
- Jun 13, 2006
- Last updated
- Feb 21, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME11514 | FL | Primary |
Addresses
Primary practice location
4495 Roosevelt Blvd
Suite 316
Jacksonville, FL 32210-3375
Mailing address
4495 Roosevelt Blvd
Suite 316
Jacksonville, FL 32210-3375
Phone (904) 384-5222
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 |
|---|---|---|---|
| 11514 | FL | MD | General Practice Dentistry |
| ME11514 | FL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Primary Care Inc | Family Medicine | Past | Accepting new patients |
| St Vincents Ambulatory Care Inc | Past | Accepting new patients | |
| Baptist Primary Care Inc | Family Medicine | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150156800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392940800000",
"number": "1811930589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4495 ROOSEVELT BLVD",
"address_2": "SUITE 316",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322103375",
"telephone_number": "904-384-5222",
"fax_number": "904-384-6468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4495 ROOSEVELT BLVD",
"address_2": "SUITE 316",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322103375",
"telephone_number": "904-384-5222",
"fax_number": "904-384-6468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PIRRUNG",
"first_name": "DAVID",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-13",
"last_updated": "2014-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME11514",
"primary": true
}
],
"identifiers": [],
"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 Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.