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  7. NPI Record 1750443412

DR. MAY ELLZA MONTRICHARD MD
Complete NPI Record 1750443412
Family Medicine in Jacksonville, FL

NPI Status: Active since December 15, 2006

Contact Information

6841 BLANDING BLVD
JACKSONVILLE, FL
ZIP 32244
Phone: (904) 862-2175
Fax: (305) 698-6536

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider Credential Text
  8. Provider First Line Business Mailing Address
  9. Provider Business Mailing Address City Name
  10. Provider Business Mailing Address State Name
  11. Provider Business Mailing Address Postal Code
  12. Provider Business Mailing Address Country Code If outside U S
  13. Provider Business Mailing Address Telephone Number
  14. Provider Business Mailing Address Fax Number
  15. Provider First Line Business Practice Location Address
  16. Provider Business Practice Location Address City Name
  17. Provider Business Practice Location Address State Name
  18. Provider Business Practice Location Address Postal Code
  19. Provider Business Practice Location Address Country Code If outside U S
  20. Provider Business Practice Location Address Telephone Number
  21. Provider Business Practice Location Address Fax Number
  22. Provider Enumeration Date
  23. Last Update Date
  24. Provider Gender Code
  25. Healthcare Provider Taxonomy Code 1
  26. Provider License Number 1
  27. Provider License Number State Code 1
  28. Healthcare Provider Primary Taxonomy Switch 1
  29. Other Provider Identifier 1
  30. Other Provider Identifier Type Code 1
  31. Other Provider Identifier State 1
  32. Other Provider Identifier Issuer 1
  33. Other Provider Identifier 2
  34. Other Provider Identifier Type Code 2
  35. Other Provider Identifier State 2
  36. Other Provider Identifier Issuer 2
  37. Other Provider Identifier 3
  38. Other Provider Identifier Type Code 3
  39. Other Provider Identifier State 3
  40. Other Provider Identifier Issuer 3
  41. Other Provider Identifier 4
  42. Other Provider Identifier Type Code 4
  43. Other Provider Identifier State 4
  44. Other Provider Identifier Issuer 4
  45. Other Provider Identifier 5
  46. Other Provider Identifier Type Code 5
  47. Other Provider Identifier State 5
  48. Other Provider Identifier Issuer 5
  49. Other Provider Identifier 6
  50. Other Provider Identifier Type Code 6
  51. Other Provider Identifier State 6
  52. Other Provider Identifier Issuer 6
  53. Other Provider Identifier 7
  54. Other Provider Identifier Type Code 7
  55. Other Provider Identifier State 7
  56. Other Provider Identifier Issuer 7
  57. Other Provider Identifier 8
  58. Other Provider Identifier Type Code 8
  59. Other Provider Identifier State 8
  60. Other Provider Identifier Issuer 8
  61. Other Provider Identifier 9
  62. Other Provider Identifier Type Code 9
  63. Other Provider Identifier State 9
  64. Other Provider Identifier Issuer 9
  65. Other Provider Identifier 10
  66. Other Provider Identifier Type Code 10
  67. Other Provider Identifier State 10
  68. Other Provider Identifier Issuer 10
  69. Other Provider Identifier 11
  70. Other Provider Identifier Type Code 11
  71. Other Provider Identifier State 11
  72. Other Provider Identifier Issuer 11
  73. Other Provider Identifier 12
  74. Other Provider Identifier Type Code 12
  75. Other Provider Identifier State 12
  76. Other Provider Identifier Issuer 12
  77. Other Provider Identifier 13
  78. Other Provider Identifier Type Code 13
  79. Other Provider Identifier State 13
  80. Other Provider Identifier Issuer 13
  81. Other Provider Identifier 14
  82. Other Provider Identifier Type Code 14
  83. Other Provider Identifier State 14
  84. Other Provider Identifier Issuer 14
  85. Is Sole Proprietor
  86. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1750443412. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1750443412
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: MAY
The first name of the provider, if the provider is an individual.
Provider Middle Name: ELLZA
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: DR.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential Text: MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 6841 BLANDING BLVD
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: JACKSONVILLE
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: FL
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 322444418
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 9048622175
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 3056986536
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 6841 BLANDING BLVD
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: JACKSONVILLE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: FL
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 32244
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9048622175
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 3056986536
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 12/15/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 10/22/2020
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 207Q00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: ME72631
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: FL
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 32845
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: FL
Other Provider Identifier Issuer 1: BCBS OF FLORIDA
Other Provider Identifier 2: 5415612
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 2: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 2: FL
Other Provider Identifier Issuer 2: AETNA
Other Provider Identifier 3: 593586793
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 3: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 3: FL
Other Provider Identifier Issuer 3: AMERICAN HERITAGE LIFE
Other Provider Identifier 4: 593586793
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 4: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 4: FL
Other Provider Identifier Issuer 4: CIGNA
Other Provider Identifier 5: 593586793
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 5: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 5: FL
Other Provider Identifier Issuer 5: AARP HEALTH CARE OPTIONS
Other Provider Identifier 6: 593586793
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 6: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 6: FL
Other Provider Identifier Issuer 6: HUMANA
Other Provider Identifier 7: 593586793
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 7: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 7: FL
Other Provider Identifier Issuer 7: PRIVATE HEALTHCARE SYSTEM
Other Provider Identifier 8: 593586793
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 8: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 8: FL
Other Provider Identifier Issuer 8: VISTA HEALTHPLAN
Other Provider Identifier 9: 206872
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 9: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 9: FL
Other Provider Identifier Issuer 9: AVMED
Other Provider Identifier 10: 593586793
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 10: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 10: FL
Other Provider Identifier Issuer 10: CHAMPUS
Other Provider Identifier 11: 593586793
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 11: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 11: FL
Other Provider Identifier Issuer 11: BANKERS LIFE & CASUALTY
Other Provider Identifier 12: 593586793
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 12: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 12: FL
Other Provider Identifier Issuer 12: UNITED HEALTHCARE
Other Provider Identifier 13: 593586793
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 13: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 13: FL
Other Provider Identifier Issuer 13: FIRST HEALTH NETWORK
Other Provider Identifier 14: 593586793
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 14: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 14: FL
Other Provider Identifier Issuer 14: TRICARE
Is Sole Proprietor: Y
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
NPI Certification Date: 10/22/2020