JACK M. MATHENY II, M.D. (NPI# 1184671844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184671844 |
| Entity Type | Organization |
| Organization Name | JACK M. MATHENY II, M.D. |
| Practice Address |
205 Zeagler Dr Ste 101 Palatka FL 32177-3888 |
| Practice Telephone | 3283286746 |
| Mailing Telephone | 3283286746 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2008-05-30 |
| Authorized Official Name | DR. JACK MEADOWS MATHENY II (OWNER) |
| Authorized Official Telephone | 3863286746 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | JACK M MATHENY II MD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 372143400 | 05 | |
| FL | 372143401 | 05 |
| Street Address |
205 ZEAGLER DR STE 101 |
| City | PALATKA |
| State | FL |
| Zip Code | 32177-3888 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265973911 | First Coast Cardiovascular | Internal Medicine | 205 Zeagler Dr, Palatka, FL 32177-3888 | 2017-03-14 |
| 1427301670 | Physicians Group Services Pa | Surgery | 205 Zeagler Dr, Palatka, FL 32177-3888 | 2012-10-24 |
| 1225262108 | Michael Allen Hicks | Nurse Practitioner | 205 Zeagler Dr, Palatka, FL 32177-3888 | 2009-05-07 |
| 1740490945 | Jeffrey Reid Slotten | Dentist | 205 Zeagler Dr, Suite 502, Palatka, FL 32177-3888 | 2007-05-23 |
| 1457561672 | Jeffrey R. Slotten | Clinic/Center | 205 Zeagler Dr, Suite 502, Palatka, FL 32177-3888 | 2007-05-23 |
| 1407066582 | Richard A. Perallon | Dentist | 205 Zeagler Dr, Suite 301, Palatka, FL 32177-3888 | 2007-05-23 |
| 1154459832 | Julie Catherine Grout | Physical Therapist | 205 Zeagler Dr, Suite 401, Palatka, FL 32177-3888 | 2007-03-02 |
| 1598810343 | Anthony J Pacitti | Surgery | 205 Zeagler Dr, Suite 203, Palatka, FL 32177-3888 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174124176 | Charlie Douglas | Pharmacist | 1024 South State Road 19, Pharmacy, Palatka, FL 32177 | 2020-11-05 |
| 1275090359 | Carol M Kazounis | Dietitian, Registered | 2801 Kennedy Strett, Palatka, FL 32177 | 2019-02-26 |
| 1447744768 | Pulido Internal Medicine | Nurse Practitioner | 700 Zeagler Drive, Suite 1, Palatka, FL 32177 | 2018-06-20 |
| 1063922656 | Ronald Michael Wendt | Nurse Practitioner | 3703 Crill Ave, Palatka, FL 32177 | 2017-10-09 |
| 1043560212 | Leslie Ann Lewis | Massage Therapist | 325 Poinsetta Ave, Palatka, FL 32177 | 2012-09-14 |
| 1285984963 | Walgreens | Pharmacy | 719 South State Road 19, Palatka, FL 32177 | 2012-09-11 |
| 1841549235 | Audrey M Russell | Pharmacy Technician | 719 Hwy 19 South, Palatka, FL 32177 | 2012-08-31 |
| 1194023838 | Sherry D. Michael | Licensed Practical Nurse | 330 Kay Larkin Dr., Palatka, FL 32177 | 2011-03-04 |
| 1083846364 | Patricia Kowalchuk | Occupational Therapy Assistant | 6050 St.johns Ave., Suite A, Palatka, FL 32177 | 2009-08-20 |
| 1609015320 | Robin Calhoun | Occupational Therapist | 611 Zeagler Dr., Palatka, FL 32177 | 2009-02-19 |
| Find all providers in zip 32177 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073642419 | Sunrise Primary Care Inc | Family Medicine | 219 N Palm Ave, Palatka, FL 32177-2627 | 2007-03-03 |
| 1063525350 | Patrick J Harris | Family Medicine | 200 Mission Rd, Palatka, FL 32177-2618 | 2006-08-17 |
| 1063434074 | Rural Health Care, Inc. | Family Medicine | 203 S Moody Rd, Palatka, FL 32177-3923 | 2006-07-25 |
| 1477519361 | Robert Pendrak | Family Medicine | 6500 Crill Ave, Palatka, FL 32177-9230 | 2006-04-21 |
| 1619944527 | Neil F Benson | Family Medicine | 108 N. Palm Ave., Palatka, FL 32177-2626 | 2006-03-01 |
| 1932171337 | Irena Maria Pacanowska-assefa | Family Medicine | 6100 Saint Johns Ave, Suite 4, Palatka, FL 32177-3844 | 2006-02-02 |
| 1629040043 | Jack M Matheny II | Family Medicine | 700 Zeagler Dr Ste 10, Palatka, FL 32177-3826 | 2006-02-02 |
| 1073511978 | Bobby R Lafferty | Family Medicine | 1302 River St, Palatka, FL 32177-5042 | 2005-07-13 |
| 1962830521 | Vip Doctors Care of Palatka LLC | Family Medicine | 800 Zeagler Dr, Suite 510, Palatka, FL 32177-3883 | 2013-10-17 |
| 1669607966 | Ellen L Talos Md Pa | Family Medicine | 200 Mission Rd, Palatka, FL 32177-2618 | 2009-05-16 |
| Find all providers in PALATKA | ||||
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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.