Individual provider Active NPI

Ronald K Charlton, PH.D.

  • Ph.D. Medical Genetics
  • Jacksonville, FL
National Provider Identifier
1962552026
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ph.D. Medical GeneticsTaxonomy code 170100000X
License
DI 28188 Issued in FL
Practice address
580 W 8TH St
Jacksonville, FL 32209-6533
Phone
(904) 244-9875
Fax
(904) 244-9861
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ph.D. Medical Genetics 170100000X DI 28188 FL Primary

Addresses

Primary practice location

580 W 8TH St
Jacksonville, FL 32209-6533

Mailing address

8221 Hidden Lake Dr N
Jacksonville, FL 32216-6321
Phone (904) 730-9625

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
DI 28188FLMDPh.D. Medical Genetics

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962552026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 HIDDEN LAKE DR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166321",
            "telephone_number": "904-730-9625",
            "fax_number": "904-244-9861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096533",
            "telephone_number": "904-244-9875",
            "fax_number": "904-244-9861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLTON",
        "first_name": "RONALD",
        "middle_name": "K",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "FL",
            "license": "DI 28188",
            "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 8, 2007; 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.