MR. KEITH A BERENS (NPI# 1174505788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174505788 |
Entity Type | Individual |
Full Name | MR. KEITH A BERENS |
Credential | PAC |
Practice Address |
1717 North E Street Suite 422 Pensacola FL 32501-6339 |
Mailing Address |
4441 La Jolla Pensacola FL 32504-7839 |
Practice Telephone | 8504447050 |
Practice Fax Number | 8504348879 |
Mailing Telephone | 8502618030 |
Enumeration Date | 2005-11-18 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9101561 | FL | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 291015200 | 05 | |
FL | BSAL | 59039584 | 01 |
Street Address |
1717 NORTH E STREET SUITE 422 |
City | PENSACOLA |
State | FL |
Zip Code | 32501-6339 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508367889 | Jessica D Nichols | Nurse Practitioner | 1717 North E Street, Tower 3, Suite 231, Pensacola, FL 32501 | 2018-02-22 |
1134509284 | Lauren A Elsas | Nurse Practitioner | 1717 North E Street, Ste 300, Pensacola, FL 32501-6336 | 2015-06-04 |
1427317882 | Andrew J Vincent | Radiology | 1717 North E Street, Ste 300, Pensacola, FL 32501-6336 | 2012-05-04 |
1699973834 | Pensacola Radiation Medicine P.a. | Radiology | 1717 North E Street, Suite 134, Pensacola, FL 32501-6339 | 2007-07-10 |
1336155977 | Peter Arthur Courcy | Surgery | 1717 North E Street, Suite 205, Pensacola, FL 32501-6336 | 2006-08-01 |
1326069113 | George Crosby Rees | Surgery | 1717 North E Street, Suite 205, Pensacola, FL 32501-6336 | 2006-07-21 |
1306867197 | Ming Ming Zhang | Surgery | 1717 North E Street, Suite 205, Pensacola, FL 32501-6336 | 2006-07-21 |
1891731188 | David R Downey | Physician Assistant | 1717 North E Street, Ste 534, Pensacola, FL 32501-6342 | 2006-06-22 |
1164480240 | Pensacola Ear Nose and Throat Pl | Otolaryngology | 1717 North E Street, Ste 239, Pensacola, FL 32501 | 2006-05-01 |
1013977941 | Langhorne Cardiology Consultants, Inc. | Internal Medicine | 1717 North E Street, Suite 331, Pensacola, FL 32501 | 2006-03-24 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669084976 | Steven Bollen | Pharmacist | 870 E Cervantes, Pensacola, FL 32501 | 2020-08-18 |
1013558733 | Erica Watts | Social Worker | 901 North I Street, Pensacola, FL 32501 | 2019-10-03 |
1972164598 | Yabin Chen | Student in an Organized Health Care Education/Training Program | Fairfield Pediatrics, 1295 W. Fairfield Drive, Pensacola, FL 32501 | 2019-06-25 |
1336700038 | Michael Enriquez | Student in an Organized Health Care Education/Training Program | Fairfield Pediatrics- Community Health Nw Fl, 1295 W Fairfield Drive, Pensacola, FL 32501 | 2019-06-24 |
1336631803 | Ana Andreea Curta | Student in an Organized Health Care Education/Training Program | Community Health Northwest Florida, 1295 W. Fairfield Drive, Pensacola, FL 32501 | 2018-05-31 |
1700374618 | Telecia Walker | Massage Therapist | 1720 W. Fairfield Dr., Ste 309, Pensacola, FL 32501 | 2018-04-26 |
1578085254 | Mary Holland Hegarty | Physical Therapist | 1000 W, Moreno St, Pensacola, FL 32501 | 2017-07-13 |
1184162455 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 1525 E Nine Mile Road, Pensacola, FL 32501 | 2017-02-07 |
1215271564 | Pathways for Change, Inc | Social Worker | 2050 West Blount Street, Pensacola, FL 32501 | 2012-11-26 |
1962697342 | Martha M Green | Family Medicine | 1717 N E St Ste 222a, Pensacola, FL 32501 | 2007-09-10 |
Find all providers in zip 32501 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891123378 | Donza First Assist | Physician Assistant | 7225 West Fairfield Dr., C-8, Pensacola, FL 32506-3488 | 2013-10-21 |
1366436362 | Mark William Houston | Physician Assistant | 4012 N 9th Ave, Pensacola, FL 32503-2824 | 2005-09-06 |
1558355545 | Anthony A Zembrzuski | Physician Assistant | 1717 N E St Ste 530, Pensacola, FL 32501 | 2005-09-06 |
1184171258 | Madeliene Hill | Physician Assistant | 1717 N E St, Pensacola, FL 32501-6339 | 2016-09-07 |
1497112270 | Sherri Peete | Physician Assistant | 1717 N E St, Pensacola, FL 32501-6339 | 2016-01-25 |
1447615554 | Jessica Sinco | Physician Assistant | 1717 N E St, Suite 208, Pensacola, FL 32501-6339 | 2015-12-17 |
1538532692 | Kaley Morris | Physician Assistant | 4724 N Davis Hwy, Pensacola, FL 32503 | 2015-11-10 |
1841607678 | Brian Scott Lang | Physician Assistant | 1717 N E St Ste 205, Pensacola, FL 32501-6336 | 2014-07-14 |
1013337435 | Kelly Demuynck | Physician Assistant | 4012 N 9th Ave, Pensacola, FL 32503-2824 | 2014-04-24 |
1417290586 | Jaclyn M Nietzer | Physician Assistant | 5151 N 9th Ave, Ste 200, Pensacola, FL 32504-8721 | 2013-03-27 |
Find all providers in PENSACOLA |
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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.