NPIMap

Organization Active NPI

Orange Park Neurosurgery P.L.

  • Neurological Surgery Physician
  • Orange Park, FL
National Provider Identifier
1861406720
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
ORANGE PARK NEUROSURGERY P.L.
Practice address
2021 Kingsley Ave
Suite 101
Orange Park, FL 32073-5174
Phone
(904) 276-3376
Fax
(904) 276-5308
NPI assigned
Jul 28, 2006
Last updated
Jan 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Authorized official

Name
Dr. Mark A Spatola, MDNPI 1437152519
Title
Managing Member
Phone
(904) 276-3376

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X NU Primary

Addresses

Primary practice location

2021 Kingsley Ave
Suite 101
Orange Park, FL 32073-5174

Mailing address

2021 Kingsley Ave
Suite 101
Orange Park, FL 32073-5174
Phone (904) 276-3376

Other identifiers 1

IdentifierTypeStateIssuer
K7538OtherFLMEDICARE PTAN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421193600000",
    "number": "1861406720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 KINGSLEY AVE",
            "address_2": "SUITE 101",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735174",
            "telephone_number": "904-276-3376",
            "fax_number": "904-276-5308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 KINGSLEY AVE",
            "address_2": "SUITE 101",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735174",
            "telephone_number": "904-276-3376",
            "fax_number": "904-276-5308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE PARK NEUROSURGERY P.L.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2015-01-14",
        "status": "A",
        "authorized_official_last_name": "SPATOLA",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "904-276-3376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K7538",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; 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.