Mark S Flynn, PSY.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY7164 Issued in FL

Practice address

1543 Kingsley Ave
Suite 18a
Orange Park, FL 32073-4535

Phone

(904) 269-3324

Fax

(904) 264-2302

NPI assigned

Jan 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Krop-Neidigh PA

  dba Community Behavioral Services

  • Psychologist
  • Orange Park, FL
  • NPI 1225197544
  Medicare reassignment
• Krop & Neidigh

  dba Community Behavioral Services

  • Clinical Psychologist
  • Orange Park, FL
  • NPI 1295700029
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1972657153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1543 KINGSLEY AVE",
            "address_2": "SUITE 18A",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734535",
            "telephone_number": "904-269-3324",
            "fax_number": "904-264-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1543 KINGSLEY AVE",
            "address_2": "SUITE 18A",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734535",
            "telephone_number": "904-269-3324",
            "fax_number": "904-264-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLYNN",
        "first_name": "MARK",
        "middle_name": "S",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 7164",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY7164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Florida Physician Specialists LLC (Urology Associates of Northeast Florida)
• Florida Sleep Solutions of Jax Inc
• Florida Woman Care LLC
• Karen M Flowers
• Brittany Floyd
• Focused Wellness Clinic LLC
• Luther Scott Foley, LPTA
• Ana Maria Fonseca Cruz
• Anika C Forbes, D.O.
• David Wayne Forbis, PA-C

• Psychologist in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.