DOMINIC LEE VAN NIELEN (NPI# 1184990590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184990590 |
| Entity Type | Individual |
| Full Name | DOMINIC LEE VAN NIELEN |
| Credential | M.D. |
| Practice Address |
554 Keily Street Jacksonville FL 32212 |
| Practice Telephone | 7579537550 |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2017-07-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 0101254468 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
554 KEILY STREET |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326019373 | Brian G Norwood | Pediatrics | 554 Keily Street, Jacksonville, FL 32212 | 2006-01-29 |
| 1811461726 | Yocelin Hernandez Rojero | Occupational Therapist | 554 Keily Street, Jacksonville Fl 32212, Jacksonville, FL 32212 | 2019-01-14 |
| 1609381235 | Miranda Shilelagh Schmidt | Physician Assistant | 554 Keily Street, Jacksonville, FL 32212 | 2017-12-05 |
| 1144733627 | Tylisha Elyse Deshields | Social Worker | 554 Keily Street, Jacksonville, FL 32212 | 2017-11-07 |
| 1326557976 | David Michael Tatera | Psychologist | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-27 |
| 1104335348 | Kuang-hui Lee | General Practice | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-20 |
| 1548788177 | Sophia Renee Beal | Speech-Language Pathologist | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-04 |
| 1164949418 | George S Bennitt | Dentist | 554 Keily Street, Jacksonville, FL 32212-4047 | 2017-08-28 |
| 1124545389 | David Phillips | Student in an Organized Health Care Education/Training Program | 554 Keily Street, Centralized Credential and Privileging Directorate, Jacksonville, FL 32212-2466 | 2017-08-28 |
| 1902323652 | Erich Chen | Student in an Organized Health Care Education/Training Program | 554 Keily Street, Jacksonville, FL 32212 | 2017-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1518484427 | Amy Kathryn Lee | Student in an Organized Health Care Education/Training Program | Bumed, Centralized Credential & Privileging Directorate, 554 Keily Street, Jacksonville, FL 32212 | 2017-08-23 |
| 1659827970 | Noah Fixelle | Dentist | Bureau of Med and Surg Ccpd, 554 Keily Street, Jacksonville, VA 32212 | 2016-08-28 |
| 1972953339 | Colin Kenneth Kelly | General Practice | Bureau of Medicine & Surgery Detachment, Nas Jacksonville, Building 554, Jacksonville, FL 32212 | 2016-06-16 |
| 1912382359 | Caitlyn Brooke Hoysock | Dentist | 554 Keiley Street, Bureau of Medicine and Surgery - Credentials, Jacksonville, FL 32212 | 2015-07-28 |
| 1285017418 | John Alexander Ruch | Dentist | 554 Keily Street Bureau of Med and Surg Ccpd, Jacksonville, FL 32212 | 2015-07-07 |
| 1407238561 | Amanda Mona Lau | Student in an Organized Health Care Education/Training Program | 554 Kelly Street, Attn Centralized Credentialing, Bureau of Medicine and Surgery, Jacksonville, FL 32212 | 2015-06-25 |
| 1063894715 | Heather Dehaan | Family Medicine | 554 Kelly Street Bureau of Medicine and Surgery, Attention: Centralized Credentialing & Privileging Dire, Jacksonville, FL 32212 | 2015-06-18 |
| 1912389677 | Catherine Garcia | Student in an Organized Health Care Education/Training Program | 554 Kelly St, Credentialing & Privileging Directorate, Bureau of Medicine & Surgery, Attention: Centralized, Jacksonville, FL 32212 | 2015-06-18 |
| 1255712675 | James Robert Benson | Dentist | 734 Keily Street, Bumed, Jacksonville, FL 32212 | 2015-06-11 |
| Find all providers in zip 32212 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609483155 | Ortholonestar, Pllc | Orthopaedic Surgery | 203 Nacogdoches St Ste 350, Jacksonville, TX 75766-2454 | 2020-09-29 |
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1013478403 | David William Barton | Orthopaedic Surgery | 655 W 8th St, Box C-126, Jacksonville, FL 32209 | 2019-03-27 |
| 1083093991 | John Wunn Cancian Sr. | Orthopaedic Surgery | Bumed, Centralized Credential and Privileging Directora, 554 Keily Street, Jacksonville, FL 32212 | 2015-05-26 |
| 1124463088 | Eric G Kim | Orthopaedic Surgery | 2 Shircliff Way Ste 605, Jacksonville, FL 32204-4762 | 2013-05-06 |
| 1508124439 | Conor Brendan Garry | Orthopaedic Surgery | Bureau of Medicine and Surgery, Central Credentialing, 554 Keily St, Jacksonville, FL 32212 | 2012-04-28 |
| 1386924298 | George El-bahri | Orthopaedic Surgery | 6100 Kennerly Rd Ste 101, Jacksonville, FL 32216-4376 | 2011-08-23 |
| 1659667012 | Michael C Freidl | Orthopaedic Surgery | Uf Health - North, 15255 Max Leggett Parkway - Suite 6600, Jacksonville, FL 32218 | 2011-06-23 |
| 1780902643 | John Webster Williams Jr. | Orthopaedic Surgery | 4416 Gadsden Ct, Jacksonville, FL 32207-6216 | 2010-05-17 |
| 1265604599 | Asher O Smith | Orthopaedic Surgery | 2080 Child Street Naval Hospital Jacksonville, Jacksonville, FL 32214-2538 | 2008-03-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32212 |
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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.