DR. KENNETH JOSEPH EADDY (NPI# 1154506376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154506376 |
| Entity Type | Individual |
| Full Name | DR. KENNETH JOSEPH EADDY |
| Credential | MD |
| Practice Address |
4063 Salisbury Rd Ste 100 Jacksonville FL 32216 |
| Mailing Address |
Po Box 16421 Greenville SC 29606-7421 |
| Practice Telephone | 9047179625 |
| Practice Fax Number | 9046836499 |
| Mailing Telephone | 9047179625 |
| Mailing Fax Number | 9046836499 |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2020-09-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | ME107723 | FL | Allopathic & Osteopathic Physicians |
| Y | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
ME107723 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 002482800 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 820 Prudential Dr Ste 304, Credentialing Department, Jacksonville, FL 322078205 | 9043463649 | 9043485627 |
| 9734 Tapestry Park Cir, Jacksonville, FL 322469906 | 2022779369 |
| Street Address |
4063 SALISBURY RD STE 100 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578669933 | Jawed Hussain | Physical Medicine & Rehabilitation | 4063 Salisbury Rd Ste 100, Jacksonville, FL 32216-6199 | 2006-09-15 |
| 1942836986 | Mallory Parrish Arinello | Physician Assistant | 4063 Salisbury Rd Ste 100, Jacksonville, FL 32216-6199 | 2020-03-22 |
| 1104460096 | Spencer Rice | Pain Medicine | 4063 Salisbury Rd Ste 100, Jacksonville, FL 32216-6199 | 2019-11-04 |
| 1356840409 | Advanced Pain Management Group, Inc. | Pain Medicine | 4063 Salisbury Rd Ste 100, Jacksonville, FL 32216-6199 | 2018-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 208VP0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Pain Medicine |
| Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient’s pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies. |
| Notes: Source: American Academy of Pain Medicine, www.painmed.org - Additional Resources:The American Board of Pain Medicine provides Board Certification. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356998975 | Haitao Zhang Md, P.a. | Pain Medicine | 3688 Burnt Pine Dr, Jacksonville, FL 32224-0870 | 2019-08-19 |
| 1013487362 | Florida Institute of Pain Medicine LLC | Pain Medicine | 2386 Dunn Ave Ste 111, Jacksonville, FL 32218-4751 | 2018-11-29 |
| 1912219064 | Emed Multispecialty Group Pa | Pain Medicine | 2624 Atlantic Boulevard, Jacksonville, FL 32204 | 2010-07-06 |
| 1013967561 | Thomas Van Holland | Pain Medicine | 5834 Normandy Blvd, Jacksonville, FL 32205-6253 | 2006-05-12 |
| 1710948856 | Gerardo Florez | Pain Medicine | 1755 University Blvd W, Jacksonville, FL 32217-2009 | 2006-03-29 |
| 1407822067 | Michael James Lupi | Pain Medicine | 11705 San Jose Blvd Ste 110, Jacksonville, FL 32223 | 2006-02-24 |
| 1720609381 | Guardian Medical Care Pllc | Pain Medicine | 943 Cesery Blvd Ste G, Jacksonville, FL 32211-5655 | 2020-05-05 |
| 1508355181 | Integrated Pain Services Inc | Pain Medicine | 4063 Salisbury Rd, Jacksonville, FL 32216-8030 | 2018-05-09 |
| 1154563591 | Courtney Melton Auman | Pain Medicine | 57 Office Park Dr, Jacksonville, NC 28546-7327 | 2009-03-31 |
| 1134282296 | Marla D Golden Do Pa | Pain Medicine | 6817 Southpoint Pkwy, Suite 1404, Jacksonville, FL 32216-6282 | 2006-12-19 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
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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.