Individual provider Active NPI

Jonathan Andrew Marx, R.R.A., R.T.(R)(ARRT

  • Radiology Practitioner Assistant
  • Lakeland, FL
National Provider Identifier
1952186108
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Practitioner AssistantTaxonomy code 243U00000X
License
RA61 Issued in FL
Practice address
2125 Crystal Grove Dr
Lakeland, FL 33801-6875
Phone
(863) 688-2334
NPI assigned
Aug 28, 2023
Last updated
Aug 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Practitioner Assistant 243U00000X RA61 FL Primary

Addresses

Primary practice location

2125 Crystal Grove Dr
Lakeland, FL 33801-6875

Mailing address

5723 Buck Run Dr
Lakeland, FL 33811-2038
Phone (859) 803-5878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RA61FLMDRadiology Practitioner Assistant

NPI Registry JSON

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1952186108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5723 BUCK RUN DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338112038",
            "telephone_number": "859-803-5878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 CRYSTAL GROVE DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338016875",
            "telephone_number": "863-688-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARX",
        "first_name": "JONATHAN",
        "middle_name": "ANDREW",
        "credential": "R.R.A., R.T.(R)(ARRT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "243U00000X",
            "taxonomy_group": "",
            "desc": "Radiology Practitioner Assistant",
            "state": "FL",
            "license": "RA61",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.