NPIMap

Organization Active NPI

Pediatric Associates of Jacksonville, PA

  • Pediatrics Physician
  • Ponte Vedra Beach, FL
National Provider Identifier
1811954126
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES OF JACKSONVILLE, PA
Practice address
2 Fairfield Blvd
Suite #11
Ponte Vedra Beach, FL 32082-4626
Phone
(904) 273-6533
Fax
(904) 280-7369
NPI assigned
Apr 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Authorized official

Name
Dr. Aylin Ozdemir, M.D.NPI 1750348009
Title
Pediatrician/President
Phone
(904) 273-6533

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2 Fairfield Blvd
Suite #11
Ponte Vedra Beach, FL 32082-4626

Mailing address

2 Fairfield Blvd
Suite #11
Ponte Vedra Beach, FL 32082-4626
Phone (904) 273-6533

Other identifiers 1

IdentifierTypeStateIssuer
99995OtherBLUECROSS BLUESHIELD

National Provider Directory

National Provider Directory

Locations

2 Fairfield Blvd
Ste 11
Ponte Vedra Beach, FL 32082
Phone (904) 273-6533

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204848000000",
    "number": "1811954126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 FAIRFIELD BLVD",
            "address_2": "SUITE #11",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824626",
            "telephone_number": "904-273-6533",
            "fax_number": "904-280-7369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 FAIRFIELD BLVD",
            "address_2": "SUITE #11",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824626",
            "telephone_number": "904-273-6533",
            "fax_number": "904-280-7369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF JACKSONVILLE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2008-03-07",
        "status": "A",
        "authorized_official_last_name": "OZDEMIR",
        "authorized_official_first_name": "AYLIN",
        "authorized_official_title_or_position": "PEDIATRICIAN/PRESIDENT",
        "authorized_official_telephone_number": "904-273-6533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "99995",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2008; 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.