SAMIA JACKSON (NPI# 1013565811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013565811 |
| Entity Type | Individual |
| Full Name | SAMIA JACKSON |
| Credential | APRN |
| Practice Address |
14444 Beach Blvd Ste 28 Jacksonville FL 32250-2080 |
| Mailing Address |
6520 Fort Caroline Rd Jacksonville FL 32277-2044 |
| Practice Telephone | 9043672277 |
| Practice Fax Number | 9044213788 |
| Mailing Telephone | 9047447300 |
| Mailing Fax Number | 9047224271 |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-09-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN11002840 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
APRN11002840 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366007098 | Samia Jackson | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204-1416 | 2019-05-08 |
| Street Address |
14444 BEACH BLVD STE 28 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32250-2080 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386710184 | Nanako Broughton | Internal Medicine | 14444 Beach Blvd Ste 28, Jacksonville, FL 32250-2080 | 2006-11-27 |
| 1699842948 | Lisa M Lynch | Physician Assistant | 14444 Beach Blvd Ste 28, Jacksonville, FL 32250 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386129591 | Kelsey Ilene Keimig | Audiologist | 3200 S 3rd Street, Ste 101, Jacksonville, FL 32250 | 2018-10-03 |
| 1225529696 | Turning Tides Eating Disorder Treatment Center, LLC. | Clinic/Center | 4300 Marsh Landings Blvd. #101, Jacksonville Beach, FL 32250 | 2018-05-22 |
| 1528578820 | Dianne Frances Gay | Dental Hygienist | 1144 14th Street North, Jacksonville Beach, FL 32250 | 2017-10-02 |
| 1801324280 | Kailo Nutrition | Dietitian, Registered | 353 B 6th Street South, Jacksonville, FL 32250 | 2017-05-30 |
| 1275985368 | Shankeertha Sundaralingam | Dentist | 3316 3rd St S Ste 101, Jacksonville Beach, FL 32250 | 2016-07-13 |
| 1851777494 | Brooke Worthington Davidson | Audiologist | 1370 13th Ave S Ste 115, Jacksonville Beach, FL 32250 | 2015-08-05 |
| 1689059115 | Jenna Levine | Speech-Language Pathologist | 779 10th Avenue South, Jacksonville Beach, FL 32250 | 2015-07-27 |
| 1790176824 | Olivia Ingram Caswell | Acupuncturist | 2902 Isabella Boulevard, Suite 50, Jacksonville Beach, FL 32250 | 2015-02-11 |
| 1467859033 | Colleen Freeman | Physical Therapist | 1537 Penman Rd, Jacksonville, FL 32250 | 2014-11-26 |
| 1356750012 | Madelyn Jones | Physical Therapist | 1320 Roberts Drive, Jacksonville Beach, FL 32250 | 2014-08-07 |
| Find all providers in zip 32250 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033729546 | Anderson Healthcare Masters LLC | Nurse Practitioner | 2332 Brian Lakes Dr E, Jacksonville, FL 32221-2802 | 2020-08-10 |
| 1336763044 | Maytin Integrated Healthcare, Inc | Nurse Practitioner | 12443 San Jose Blvd Ste 403, Jacksonville, FL 32223-8650 | 2020-05-29 |
| 1821628207 | Latasha Wiley | Nurse Practitioner | 11698 Alexandra Dr, Jacksonville, FL 32218-8874 | 2020-01-24 |
| 1396204871 | Tanza L Walker | Nurse Practitioner | 6135 Ricker Rd, Jacksonville, FL 32244-2605 | 2019-03-14 |
| 1437622107 | Michelle Espanol Garcia | Nurse Practitioner | 9957 Moorings Dr Ste 204, Jacksonville, FL 32257 | 2019-01-05 |
| 1972087682 | Telicia Fisher | Nurse Practitioner | 11634 Brian Lakes Dr, Jacksonville, FL 32221-2855 | 2018-09-18 |
| 1629555834 | Jose R Garcia | Nurse Practitioner | 9310 Old Kings Rd S Ste 1303, Jacksonville, FL 32257-8100 | 2018-07-20 |
| 1730694290 | David Jonathan Tonto | Nurse Practitioner | 11250 Baptist Health Dr, Jacksonville, FL 32218-2978 | 2017-12-06 |
| 1316293384 | Marta Kay Spaulding Wells | Nurse Practitioner | 13720 Weeping Willow Way, Jacksonville, FL 32224-6899 | 2012-07-27 |
| 1316057029 | Kristine H Thompson | Nurse Practitioner | 2563 Oak St, Jacksonville, FL 32204-4559 | 2006-08-30 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32250 |
Please comment or provide details below to improve the information on SAMIA JACKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.