NPIMap

Organization Active NPI

Jax Anesthesia Providers

  • Ambulatory Surgical Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1962587741
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
2217 Issued in FL
Legal business name
JAX ANESTHESIA PROVIDERS
Practice address
1610 Barrs St
Jacksonville, FL 32204-4569
Phone
(904) 483-5850
Fax
(904) 483-5860
NPI assigned
Oct 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jack R Groover, MD
Title
Ceo
Phone
(904) 398-7205

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 2217 FL Primary

Addresses

Primary practice location

1610 Barrs St
Jacksonville, FL 32204-4569

Mailing address

4800 Belfort Rd
Jacksonville, FL 32256-6004
Phone (904) 483-5850

National Provider Directory

National Provider Directory
Tax ID family
Jax Anesthesia Providers2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4800 Belfort Rd
Jacksonville, FL 32256
Phone (904) 307-2084

1610 Barrs St
Jacksonville, FL 32204
Phone (904) 388-9361

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962587741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566004",
            "telephone_number": "904-483-5850",
            "fax_number": "904-483-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 BARRS ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044569",
            "telephone_number": "904-483-5850",
            "fax_number": "904-483-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAX ANESTHESIA PROVIDERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GROOVER",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-398-7205",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "2217",
            "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 Aug 22, 2020; 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.