Emily Ivy Painter, CPO

Primary specialty

OrthotistTaxonomy code 222Z00000X

Practice address

1536 N Jefferson St
Jacksonville, FL 32209-6525

Phone

(904) 881-4721

NPI assigned

Jun 24, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Emily Ivy Gonzalez-Ortega Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1656028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1972235448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3342 GREEN ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322055712",
            "telephone_number": "904-881-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 N JEFFERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096525",
            "telephone_number": "904-881-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAINTER",
        "first_name": "EMILY",
        "middle_name": "IVY",
        "credential": "CPO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS AND PROSTHETICS",
            "identifier": "CPO03466",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "GONZALEZ-ORTEGA",
            "middle_name": "IVY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mark Painter, BCCC
• Krystal Imani Paisley, AS, LMT
• Raymond Pak, MD
• Sang-Woo Pak, M.D.
• Song Hyon Pak, M.D.

• Orthotist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Orthotist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.