NPIMap

Organization Active NPI

Children'S Health Associates

  • Pediatrics Physician
  • Jacksonville, FL
National Provider Identifier
1831639400
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
CHILDREN'S HEALTH ASSOCIATES
Practice address
3710 Grandy Ave
Jacksonville, FL 32207-6112
Phone
(904) 398-5561
Fax
(904) 398-1460
NPI assigned
Mar 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Authorized official

Name
Mrs. Laura Windle
Title
Manager
Phone
(904) 228-2402

Specialties & licenses 1

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

Addresses

Primary practice location

3710 Grandy Ave
Jacksonville, FL 32207-6112

Mailing address

3710 Grandy Ave
Jacksonville, FL 32207-6112
Phone (904) 398-5561

Other identifiers 4

IdentifierTypeStateIssuer
370220100MedicaidFL
044852400MedicaidFL
013036900MedicaidFL
271799900MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
John Assi MD PA9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488412800000",
    "number": "1831639400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 GRANDY AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322076112",
            "telephone_number": "904-398-5561",
            "fax_number": "904-398-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 GRANDY AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322076112",
            "telephone_number": "904-398-5561",
            "fax_number": "904-398-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S HEALTH ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-02",
        "last_updated": "2017-03-02",
        "status": "A",
        "authorized_official_last_name": "WINDLE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "904-228-2402",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370220100",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044852400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013036900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271799900",
            "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 Mar 2, 2017; 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.