Vijay K Jain, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME105813 Issued in FL

Practice address

25 Florida Park Dr N
Palm Coast, FL 32137-3806

Phone

(270) 566-1073

NPI assigned

Jan 12, 2006

Last updated

Oct 15, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lung and Sleep Disorder Institute PLLC

  • Specialist
  • Somerset, KY
  • NPI 1376688614
  NPD (past)
• Mary Rutan Hospital

  dba Mad River Family Practice

  • Family Medicine Physician
  • West Liberty, OH
  • NPI 1003875949
  NPD (past)

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1902885551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 FLORIDA PARK DR N",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373806",
            "telephone_number": "270-566-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 FLORIDA PARK DR N",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373806",
            "telephone_number": "270-566-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "VIJAY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME105813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Kay Jackson
• Jade Jackson, L.D.O
• Jeremy Jackson
• Ronald F Jacob, DDS
• Andrew T Jacquay, DPT
• Henry James, N/A
• Samaria S James, RN
• Jane Walter D.P.M., P.a.
• Joseph Lawrence Jardine
• Jayraj J. Patel D.M.D P.L.L.C (Palm Coast Family Dentistry)

• Family Medicine Physician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.