First Coast Podiatry, P a

Primary specialty

PodiatristTaxonomy code 213E00000X

License

PO2487 Issued in FL

Legal business name

FIRST COAST PODIATRY, P A

Practice address

3115 Spring Glen Rd Ste 507
Jacksonville, FL 32207-5907

Phone

(904) 354-1192

Fax

(904) 354-1193

NPI assigned

Nov 30, 2007

Organization subpart

No

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

Authorized official

Name

Jaynell Smith-Cameron, DPMNPI 1235276189

Title

Podiatrist

Phone

(904) 354-1192

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaynell Smith-Cameron, DPM

  • Foot & Ankle Surgery Podiatrist
  • Jacksonville, FL
  • NPI 1235276189
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1881876902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 SPRING GLEN RD STE 507",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075907",
            "telephone_number": "904-354-1192",
            "fax_number": "904-354-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 SPRING GLEN RD STE 507",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075907",
            "telephone_number": "904-354-1192",
            "fax_number": "904-354-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST PODIATRY, P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "SMITH-CAMERON",
        "authorized_official_first_name": "JAYNELL",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "904-354-1192",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO2487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340105700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• First Coast Pathology Associates, LLC
• First Coast Periodontics, PA
• First Coast Physical Medicine Inc
• First Coast Plastic Surgery PA
• First Coast Podiatric Surgery and Wound Care LLC
• First Coast Primary Care Inc
• First Coast Retina Center PA
• First Coast Speech Services, LLC
• First Coast Spine, Inc.
• First Coast Surgical Associates Inc

• Podiatrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.