JEAN HELEN MCCLINTOCK (NPI# 1134167687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134167687 |
| Entity Type | Individual |
| Full Name | JEAN HELEN MCCLINTOCK |
| Credential | MD |
| Practice Address |
11512 Lake Mead Ave Suite 401 Jacksonville FL 32256-9680 |
| Practice Telephone | 9047311770 |
| Practice Fax Number | 9049968300 |
| Mailing Telephone | 9047311770 |
| Mailing Fax Number | 9049968300 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2015-05-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | ME71302 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | WELLCARE | 11003 | 01 |
| FL | BCBS | 31588 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619979507 | Jean Mcclintock | Obstetrics & Gynecology | 7777 Forest Ln, C-234, Dallas, TX 75230-2505 | 2005-08-11 |
| Street Address |
11512 LAKE MEAD AVE SUITE 401 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32256-9680 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205831906 | Jerome O Sugar | Otolaryngology | 11512 Lake Mead Ave, Ste 531, Jacksonville, FL 32256-9680 | 2005-06-17 |
| 1952949166 | Savannah Moore | Speech-Language Pathologist | 11512 Lake Mead Ave, Jacksonville, FL 32256-9680 | 2019-12-18 |
| 1225594427 | Celena Allen | Nurse Practitioner | 11512 Lake Mead Ave, Jacksonville, FL 32256-9680 | 2019-02-13 |
| 1306300017 | Tara Elizabeth Strange | Speech-Language Pathologist | 11512 Lake Mead Ave, Jacksonville, FL 32256-9680 | 2019-01-27 |
| 1457826810 | Annette Marie Tharp-wright | Counselor | 11512 Lake Mead Ave, Jacksonville, FL 32256-9680 | 2018-10-11 |
| 1023515418 | Samantha J Barry | Nurse Practitioner | 11512 Lake Mead Ave, Jacksonville, FL 32256-9680 | 2018-04-11 |
| 1073068235 | Juliann Abecassis | Acupuncturist | 11512 Lake Mead Ave, Suite 605, Jacksonville, FL 32256-9680 | 2016-08-17 |
| 1568915387 | Jacksonville Dental Specialists | Dentist | 11512 Lake Mead Ave, Ste. 532, Jacksonville, FL 32256-9680 | 2016-07-28 |
| 1972957272 | Kayla Raulerson | Behavioral Analyst | 11512 Lake Mead Ave, Suite 601, Jacksonville, FL 32256-9680 | 2016-04-22 |
| 1710331830 | Anna Beth Baden | Behavioral Analyst | 11512 Lake Mead Ave, Suite 601, Jacksonville, FL 32256-9680 | 2016-04-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
| 1093327702 | Oaktree Dental LLC | Clinic/Center | 14595 Philips Highway, Jacksonville, FL 32256 | 2020-08-24 |
| 1538787866 | Tywanna Council | Massage Therapist | 4720 Salisbury Road #102, Jacksonville, FL 32256 | 2020-07-13 |
| 1275155368 | Christy Orellana | Social Worker | 5011 Gate Parkway Bldg 100 Suite 100, Jacksonville, FL 32256 | 2020-05-11 |
| 1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
| 1982235859 | Sandra Josefina Baez Nunez | Nurse Practitioner | 10739 Deerwood Park Blvd, Suite 200, Jacksonville, FL 32256 | 2020-01-30 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1003472499 | Dade Medical, Inc. | Durable Medical Equipment & Medical Supplies | 9143 Philips Highway Suite 270, Jacksonville, FL 32256 | 2019-05-13 |
| 1003479726 | Nichole Bashara | Behavior Technician | 8383 Baymeadows Rd, Jacksonville, FL 32256 | 2019-04-18 |
| Find all providers in zip 32256 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902291784 | Brandon Tyler Beal | Dermatology | 6817 Southpoint Pkwy Ste 101, Jacksonville, FL 32216-6285 | 2015-03-30 |
| 1194079988 | Intracoastal Dermatology, Pllc | Dermatology | 4776 Hodges Blvd Ste 105, Jacksonville, FL 32224-7218 | 2012-11-01 |
| 1780861781 | Jacksonville Skin Cancer Center, P.a. | Dermatology | 4465 Baymeadows Rd Ste 5, Jacksonville, FL 32217-4727 | 2008-01-22 |
| 1720272644 | John Morello | Dermatology | 13111 Atlantic Blvd., Ste 4, Jacksonville, FL 32225 | 2007-09-04 |
| 1982740775 | Michael Edward Lutz | Dermatology | 4465 Baymeadows Rd, Suite 5, Jacksonville, FL 32217 | 2007-01-29 |
| 1386757540 | Joy R Boyne | Dermatology | 6869 Belfort Oaks Pl, Jacksonville, FL 32216-6242 | 2006-08-15 |
| 1124063391 | Robert Alan Baker | Dermatology | 11701-32 San Jose Blvd, Suite 216, Jacksonville, FL 32223 | 2006-06-19 |
| 1770521163 | James W Trimble | Dermatology | 6890 Belfort Oaks Pl, Jacksonville, FL 32216-6241 | 2006-06-04 |
| 1497709778 | Daniel J Abraham | Dermatology | 215b Station St, Jacksonville, NC 28546-6304 | 2006-05-20 |
| 1124076492 | Michael A. Gromet | Dermatology | 10036 Scott Mill Rd, Jacksonville, FL 32257-5885 | 2006-05-05 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32256 |
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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.