Medicussx Spine & Joint, LLC

Primary specialty

Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X

Legal business name

MEDICUSSX SPINE & JOINT, LLC

Practice address

4540 Southside Blvd
Jacksonville, FL 32216

Phone

(904) 503-1065

Fax

(904) 374-6075

NPI assigned

Apr 22, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Jason T. Marucci, DC

Title

Ceo

Phone

(904) 503-1065

Specialties & licenses 4

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681171200000",
    "number": "1932729639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 SOUTHSIDE BLVD",
            "address_2": "SUITE 202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-503-1065",
            "fax_number": "904-374-6075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 SOUTHSIDE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-503-1065",
            "fax_number": "904-374-6075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICUSSX SPINE & JOINT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-22",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A",
        "authorized_official_last_name": "MARUCCI",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-503-1065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "admin@medicus4u.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4540 Southside Blvd Ste 202",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322165488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Orthopaedic Surgery of the Spine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Orthopaedic Surgery of the Spine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.