Randy James Prokes, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME45570 Issued in FL

Practice address

13457 Atlantic Blvd
Suite 5
Jacksonville, FL 32225-3293

Phone

(904) 221-9110

Fax

(904) 220-9110

NPI assigned

May 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Solantic of Jacksonville, LLC

  • Urgent Care Clinic/Center
  • Ponte Vedra, FL
  • NPI 1407893100

  Family Medicine

  Medicare reassignment NPD
• Omega Health and Nutrition LLC

  • Nutritionist
  • Jacksonville, FL
  • NPI 1134619208
  NPD (past)
• Solantic LLC

  • Urgent Care Clinic/Center
  • Jacksonville, FL
  • NPI 1609822592
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1831147404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13457 ATLANTIC BLVD",
            "address_2": "SUITE 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322253293",
            "telephone_number": "904-221-9110",
            "fax_number": "904-220-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13457 ATLANTIC BLVD",
            "address_2": "SUITE 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322253293",
            "telephone_number": "904-221-9110",
            "fax_number": "904-220-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROKES",
        "first_name": "RANDY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME45570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Progressus Therapy, LLC
• Prohealth Dentist FL PLLC
• Lianelis Rafaela Prohenza Macias
• Richard R Proia, MD
• Project Health & Esthetics, Inc.
• Prolab Solutions LLC
• Promedical Transportation, LLC
• Promise to Care Homemaker Companion Services LLC
• Promising Love Personal & Home Care Services L.L.C
• Prophetic Healing Deliverance Ministry of Mysteries, Inc

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.