NPIMap

Organization Active NPI

Physicians Medical Center Northside Inc

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1891069449
Registry record updated Feb 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
FL7438 Issued in FL
Legal business name
PHYSICIANS MEDICAL CENTER NORTHSIDE INC
Practice address
1840 Dunn Ave
Suite 1
Jacksonville, FL 32218-4799
Phone
(904) 757-2527
Fax
(904) 757-3656
NPI assigned
Feb 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2012

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

Authorized official

Name
Dr. Richard Edgar Kersey Jr., D.D.
Title
President
Phone
(904) 757-2527

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X FL7438 FL Primary

Addresses

Primary practice location

1840 Dunn Ave
Suite 1
Jacksonville, FL 32218-4799

Mailing address

1840 Dunn Ave
Suite 1
Jacksonville, FL 32218-4799
Phone (904) 757-2527

National Provider Directory

National Provider Directory

Locations

1840 Dunn Ave
Ste 1
Jacksonville, FL 32218
Phone (904) 757-2527

NPI Registry JSON

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330473600000",
    "number": "1891069449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 DUNN AVE",
            "address_2": "SUITE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184799",
            "telephone_number": "904-757-2527",
            "fax_number": "904-757-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 DUNN AVE",
            "address_2": "SUITE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184799",
            "telephone_number": "904-757-2527",
            "fax_number": "904-757-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS MEDICAL CENTER NORTHSIDE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-29",
        "last_updated": "2012-02-29",
        "status": "A",
        "authorized_official_last_name": "KERSEY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "EDGAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-757-2527",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "FL7438",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 29, 2012; 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.