JACKSONVILLE PEDIATRICS (NPI# 1043346745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043346745 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE PEDIATRICS |
| Practice Address |
2606 Park St Jacksonville FL 32204-4520 |
| Practice Telephone | 9043884646 |
| Practice Fax Number | 9043889071 |
| Mailing Telephone | 9043884646 |
| Mailing Fax Number | 9043889071 |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. RANDOLPH EDENS THORNTON (SENIOR PHYSICIAN) |
| Authorized Official Telephone | 9043894140 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
========= | FL | Allopathic & Osteopathic Physicians |
| Street Address |
2606 PARK ST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-4520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487625398 | Nan S Mcclelland | Pediatrics | 2606 Park St, Jacksonville, FL 32204-4520 | 2006-01-30 |
| 1508156795 | Ryan Cantville | Pediatrics | 2606 Park St, Jacksonville, FL 32204-4520 | 2011-04-09 |
| 1124334156 | Kerry Lynn Ebueng | Nurse Practitioner | 2606 Park St, Jacksonville, FL 32204-4520 | 2010-08-27 |
| 1821314683 | Cathleen Helena Southall | Nurse Practitioner | 2606 Park St, Jacksonville, FL 32204-4520 | 2010-04-19 |
| 1750352647 | Randolph E Thornton | Pediatrics | 2606 Park St, Jacksonville, FL 32204-4520 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1841794682 | W.b. Stewart Tigers Athletics Boosters | Pediatrics | 1658 Kings Rd, Jacksonville, FL 32209-6167 | 2018-03-19 |
| 1487755567 | Charles Richardson Martin | Pediatrics | 2 Dewitt St, Jacksonville, NC 28540-5649 | 2006-09-25 |
| 1336252444 | Charles B. Mcintosh | Pediatrics | 3160 Edgewood Ave W, Jacksonville, FL 32209-2245 | 2006-08-16 |
| 1922091156 | Anne T Egan | Pediatrics | 2121 Park St, Jacksonville, FL 32204-3811 | 2005-08-23 |
| 1326046350 | Iris Eisenberg | Pediatrics | 11521 N Main St, Jacksonville, FL 32218-4002 | 2005-07-13 |
| 1568856698 | Afton Turner | Pediatrics | 4788 Hodges Blvd Ste B108, Jacksonville, FL 32224-7222 | 2015-03-26 |
| 1316385164 | Rainbow Pediatric Center | Pediatrics | 4788 Hodges Blvd, Suite B-108, Jacksonville, FL 32224-7222 | 2013-06-13 |
| 1043456148 | Rachna A Krish | Pediatrics | 13241 Bartram Park Blvd, Suite # 209, Jacksonville, FL 32258-5212 | 2008-12-20 |
| 1609925387 | Erica Tarbox | Pediatrics | 3945 San Jose Park Dr, Jacksonville, FL 32217-4612 | 2007-01-10 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
Please comment or provide details below to improve the information on JACKSONVILLE PEDIATRICS.
| 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.