Individual provider Active NPI

James Michael Kilcoyne, DDS

  • General Practice Dentistry
  • Jacksonville, FL
National Provider Identifier
1972560829
Registry record updated Nov 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN 6028 Issued in FL
Practice address
9109 Baymeadows Rd
Suite 4
Jacksonville, FL 32256-2014
Phone
(904) 731-0311
Fax
(904) 731-0312
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN 6028 FL Primary

Addresses

Primary practice location

9109 Baymeadows Rd
Suite 4
Jacksonville, FL 32256-2014

Mailing address

9109 Baymeadows Rd
Suite 4
Jacksonville, FL 32256-2014
Phone (904) 731-0311

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
DN 6028FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Maples, Neal and Winter General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1972560829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9109 BAYMEADOWS RD",
            "address_2": "SUITE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322562014",
            "telephone_number": "904-731-0311",
            "fax_number": "904-731-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9109 BAYMEADOWS RD",
            "address_2": "SUITE 4",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322562014",
            "telephone_number": "904-731-0311",
            "fax_number": "904-731-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILCOYNE",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 6028",
            "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 Nov 6, 2009; 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.