MARY STEPHENS MATHIS (NPI# 1053446690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053446690 |
| Entity Type | Individual |
| Full Name | MARY STEPHENS MATHIS |
| Credential | PA |
| Practice Address |
120 Gateway Cir Unit 1 Jacksonville FL 32259-4082 |
| Mailing Address |
Po Box 45443 Salt Lake City UT 84145-0443 |
| Practice Telephone | 9048244407 |
| Practice Fax Number | 9048247855 |
| Mailing Telephone | 9042021032 |
| Mailing Fax Number | 9043763107 |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2018-12-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9103761 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RR MEDICARE | P00944724 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679693006 | Mary Susan Mathis | Counselor | 1261b Cheraw Rd, Cassatt, SC 29032 | 2007-03-30 |
| 1386245736 | Mary Margaret Mathis | Counselor | 8411 Broadway Ave, Cleveland, OH 44105-3932 | 2020-11-03 |
| 1942582143 | Mary Anne Mathis | Behavioral Analyst | 2325 S Harvard Ave, Tulsa, OK 74114-3300 | 2011-09-13 |
| 1548565005 | Mary Kristina Mathis | Speech-Language Pathologist | 625 Overlook Dr, Winter Haven, FL 33884-1626 | 2011-01-14 |
| 1720043730 | Mary Carol Mathis | Audiologist | 1330 Boiling Springs Rd, Suite 1400, Spartanburg, SC 29303-2244 | 2006-04-20 |
| 1528041985 | Mary E Mathis | Nurse Anesthetist, Certified Registered | 3705 Medical Pkwy, Suite 570, Austin, TX 78705-1019 | 2005-11-21 |
| Street Address |
120 GATEWAY CIR UNIT 1 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32259-4082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629250915 | Baptist Primary Care Inc | Family Medicine | 120 Gateway Cir, Unit 1, Jacksonville, FL 32259-4082 | 2007-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659904571 | Ayla Rose Yarbrough | Chiropractor | 1620 County Road 210, St. Johns County, FL 32259 | 2020-02-19 |
| 1831731009 | Andrew Dacunha, Dmd, Pa | Dentist | 71 Doctors Village Drive, Suite 303, Saint Johns, FL 32259 | 2019-10-09 |
| 1801446257 | Mary Alice Taylor | Counselor | 213 Trapper Trace Ct., St. Johns, FL 32259 | 2019-09-18 |
| 1609425826 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 155 Bartram Park Drive, Suite 100, St. Johns, FL 32259 | 2019-09-10 |
| 1518438936 | Yazji Pediatric Care | Pediatrics | 4125 Race Track Rd, Suite Number 104, Saint Johns, FL 32259 | 2018-12-11 |
| 1003328022 | Abundant Life Health Center LLC | Chiropractor | 254 Everest Lane, St. Johns, FL 32259 | 2017-10-31 |
| 1356863732 | Jennifer Eberhard | Nurse Practitioner | 335 Oxford Estates Way, Saint Johns, FL 32259 | 2017-07-07 |
| 1366986861 | Taylor Leard | Physician Assistant | 2001 County Rd 210, Suite 101, St. Johns, FL 32259 | 2016-12-19 |
| 1043760390 | Comfortable Care Dental Health Professionals, Pa | Dentist | 2532 Race Track Rd, Saint Johns, FL 32259 | 2016-10-11 |
| 1598114233 | Bright Smiles Pediatric Dentistry, Pllc | Dentist | 196 Everest Ln Unit 1, Saint Johns, FL 32259 | 2016-06-03 |
| Find all providers in zip 32259 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831799527 | Emily Vander Zee | Physician Assistant | 6680 Bennett Creek Dr Apt 213, Jacksonville, FL 32216-0018 | 2020-10-30 |
| 1245830314 | Jonathan V Korah | Physician Assistant | 6650 Corporate Center Pkwy Apt 1108, Jacksonville, FL 32216-8725 | 2020-10-28 |
| 1255931473 | Rachel Gavrielle Stahly | Physician Assistant | 11438 Emuness Rd, Jacksonville, FL 32218-4050 | 2020-10-27 |
| 1760099071 | Laura Alexandra Ramos-heckman | Physician Assistant | 2014 Capistrano Dr, Jacksonville, FL 32224-3091 | 2020-09-30 |
| 1184230583 | Julian Clouse | Physician Assistant | 9803 Creekfront Rd Apt 307, Jacksonville, FL 32256-8449 | 2020-09-21 |
| 1962016717 | Stephanie Benton Gentry | Physician Assistant | 3179 Shadow Creek Rd, Jacksonville, FL 32226-2386 | 2020-08-31 |
| 1629689435 | Monarch Mental Health Association | Physician Assistant | 5393 Roosevelt Blvd Ste 8, Jacksonville, FL 32210-8424 | 2020-08-14 |
| 1235749425 | Nicole Lhommedieu | Physician Assistant | 3850 Marnie Pl, Jacksonville, FL 32223-3541 | 2020-08-03 |
| 1861002123 | Naw-am Acio Daniels | Physician Assistant | 7467 Volley Dr N, Jacksonville, FL 32277-9368 | 2020-08-03 |
| 1750906640 | Veronica Adriana Dediego | Physician Assistant | 915 W Monroe St Ste 300, Jacksonville, FL 32204-1177 | 2020-06-16 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32259 |
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| 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.