Kingsley Endoscopy Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

KINGSLEY ENDOSCOPY CENTER LLC

Practice address

870 Kingsley Ave
Orange Park, FL 32073-4752

Phone

(904) 388-8686

Fax

(904) 387-2659

NPI assigned

Sep 1, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Abdu Abbassi, MD

Title

Owner

Phone

(904) 388-8686

Specialties & licenses 1

Addresses

Electronic endpoints 1

Listed as

Kingsley Endoscopy Center LLCCCN 10C0001685

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 1

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

• Abdi Abbassi, M.D.

  • Gastroenterology Physician
  • Jacksonville, FL
  • NPI 1831183938
  NPD (past)

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1891309423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044416",
            "telephone_number": "904-388-8686",
            "fax_number": "904-387-2659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734752",
            "telephone_number": "904-388-8686",
            "fax_number": "904-387-2659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSLEY ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-01",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "ABBASSI",
        "authorized_official_first_name": "ABDU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-388-8686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "OTHER",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "OTHER",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "970 KINGSLEY AVENUE",
            "city": "ORANGE PARK",
            "state": "FL",
            "country_code": "US",
            "postal_code": "32073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shameka Danielle King, ARNP
• Tiffani King, MD
• Kingdom Care Living Homemaker and Companion Services, LLC
• Kingdom Services of Jacksonville LLC
• Kingsley Avenue Emergency Physicians LLC
• Kingsley RX LLC
• Chamonix Kinimaka, MD
• Jullia C. Kinser, DMD
• Paula A Kircher, LCSW
• Leigh Kirchner, M.A.,CCC-SLP

• Ambulatory Surgical Clinic/Center in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.