NPIMap

Organization Active NPI

Memorial Family Practice Associates LLC

Doing business as Jacksonville Family Practice Associates

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1851333108
Registry record updated Jan 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEMORIAL FAMILY PRACTICE ASSOCIATES LLC
Doing business as
Jacksonville Family Practice Associates
Practice address
1731 University Blvd S
Jacksonville, FL 32216-8928
Phone
(904) 725-6544
Fax
(904) 721-5711
NPI assigned
Jun 12, 2006
Last updated
Jan 21, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2008

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

Authorized official

Name
Mickey Pickler
Title
VP
Phone
(904) 725-6544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

1731 University Blvd S
Jacksonville, FL 32216-8928

Mailing address

1731 University Blvd S
Jacksonville, FL 32216-8928
Phone (904) 725-6544

Other names 1

  • Jacksonville Family Practice Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Memorial Family Practice Associates LLC8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200873600000",
    "number": "1851333108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168928",
            "telephone_number": "904-725-6544",
            "fax_number": "904-721-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168928",
            "telephone_number": "904-725-6544",
            "fax_number": "904-721-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL FAMILY PRACTICE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2008-01-21",
        "status": "A",
        "authorized_official_last_name": "PICKLER",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "904-725-6544"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacksonville Family Practice Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 21, 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.