NPIMap

Organization Active NPI

Reuben Maggard M.D. P.a.

  • Nephrology Physician
  • Orange Park, FL
National Provider Identifier
1982095972
Registry record updated Feb 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME112969 Issued in FL
Legal business name
REUBEN MAGGARD M.D. P.A.
Practice address
2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone
(606) 233-5555
Fax
(904) 642-6262
NPI assigned
Feb 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2015

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

Authorized official

Name
Wendy C Lu
Title
Credentialing Coordinator
Phone
(904) 221-2535

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X ME112969 FL Primary

Addresses

Primary practice location

2001 Kingsley Ave
Orange Park, FL 32073-5148

Mailing address

PO Box 551099
Jacksonville, FL 32255-1099
Phone (606) 233-5555

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1423612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423612800000",
    "number": "1982095972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551099",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322551099",
            "telephone_number": "606-233-5555",
            "fax_number": "904-642-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735148",
            "telephone_number": "606-233-5555",
            "fax_number": "904-642-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REUBEN MAGGARD M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-11",
        "last_updated": "2015-02-11",
        "status": "A",
        "authorized_official_last_name": "LU",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "904-221-2535"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME112969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2015; 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.