Active NPI
Mark M Carter, M.D.
- Diagnostic Radiology Physician
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- ME47719
- Practice address
- 4521 Shiloh Mill Blvd
Jacksonville, FL 32246-1880 - Phone
- (904) 699-4337
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD421030 | PA | |
| Diagnostic Radiology Physician | 2085R0202X | ME47719 | FL | Primary |
Addresses
Primary practice location
4521 Shiloh Mill Blvd
Jacksonville, FL 32246-1880
Mailing address
4521 Shiloh Mill Blvd
Jacksonville, FL 32246
Phone (904) 699-4337
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 061625700 | Medicaid | FL |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Florida College of Medicine, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4800 Belfort Rd
Jacksonville, FL 32256-6004
Phone (904) 398-7205
836 Prudential Dr
Suite 801
Jacksonville, FL 32207-8335
Phone (904) 288-0433
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.94 of 100
- Quality
- 69.69
- Promoting interoperability
- 89
- Improvement activities
- 40
- Cost
- 69.28
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME47719 | FL | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Borland Groover Clinic, PA | Diagnostic Radiology | Current | Accepting new patients |
| Frank Olney & Rudy Nicolas PTRS | Diagnostic Radiology | Past | Accepting new patients |
Locations
836 Prudential Dr
Ste 801
Jacksonville, FL 32207
Phone (904) 288-0433
4800 Belfort Rd
Jacksonville, FL 32256
Phone (904) 307-2084
Interoperability endpoints
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Gastroenterology Physician
- Jacksonville, FL
- NPI 1881644912
Diagnostic Radiology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409097600000",
"number": "1932128337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4521 SHILOH MILL BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32246",
"telephone_number": "904-699-4337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4521 SHILOH MILL BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322461880",
"telephone_number": "904-699-4337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "MARK",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2014-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "PA",
"license": "MD421030",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "FL",
"license": "ME47719",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "061625700",
"state": "FL"
}
],
"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 Aug 27, 2014; 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.
- 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.