Organization Active NPI

Sugar Doctors LLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Jacksonville, FL
National Provider Identifier
1922612886
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
SUGAR DOCTORS LLC
Practice address
8613 Old Kings Rd S Ste 301
Jacksonville, FL 32217-4845
Phone
(904) 280-6650
NPI assigned
Sep 8, 2020
Last updated
Jul 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Authorized official

Name
John A Purcell, MDNPI 1235133505
Title
Manager
Phone
(904) 514-6331

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

8613 Old Kings Rd S Ste 301
Jacksonville, FL 32217-4845

Mailing address

PO Box 347
St Augustine, FL 32085-0347
Phone (904) 280-6650

Other practice location 1

423 Highway 466 Apt 8206
Lady Lake, FL 32159-6307
Phone (904) 514-6331

Other practice location 2

1451 El Caminio Real
The Villages, FL 32159-0041
Phone (904) 514-6331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201204001784 FL Part B Supplier - Clinic/Group Practice 8921419482 Receives reassigned benefits from 1 practitioner
Practice locations: Lady Lake, FL; The Villages, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1922612886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 347",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320850347",
            "telephone_number": "904-280-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8613 OLD KINGS RD S STE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174845",
            "telephone_number": "904-280-6650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "423 Highway 466 Apt 8206",
            "address_purpose": "LOCATION",
            "city": "Lady Lake",
            "state": "FL",
            "postal_code": "321596307",
            "country_code": "US",
            "telephone_number": "904-514-6331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1451 El Caminio Real",
            "address_purpose": "LOCATION",
            "city": "The Villages",
            "state": "FL",
            "postal_code": "321590041",
            "country_code": "US",
            "telephone_number": "904-514-6331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUGAR DOCTORS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-08",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "PURCELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "904-514-6331",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "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 Jul 28, 2022; 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.