JACK EDWARD CONEBY (NPI# 1265712343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265712343 |
| Entity Type | Individual |
| Full Name | JACK EDWARD CONEBY |
| Credential | RNBC |
| Practice Address |
3820 Central Ave St Petersburg FL 33711-1237 |
| Practice Telephone | 7275439416 |
| Mailing Telephone | 7275439416 |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2011-08-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
RN1461352 | FL | Nursing Service Providers |
| Street Address |
3820 CENTRAL AVE |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33711-1237 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114289261 | Debra Berard | Registered Nurse | 3820 Central Ave, St Petersburg, FL 33711-1237 | 2012-06-14 |
| 1679832257 | Gina M Miller | Registered Nurse | 3820 Central Ave, St Petersburg, FL 33711-1237 | 2012-05-16 |
| 1043335433 | Lynda H Wagner | Counselor | 3820 Central Ave, St Petersburg, FL 33711-1237 | 2007-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639665110 | Armando Alvarez Gonzalez | Nurse Practitioner | 3404 26th Ave S, St Petersburg, FL 33711 | 2018-07-08 |
| 1508398843 | S&r Cares LLC | Preferred Provider Organization | 4201 4th Avenue South Street, St Petersburg, FL 33711 | 2017-03-28 |
| 1245691062 | Brian Paulson | Counselor | 4024 Central Ave # 1239, Saint Petersburg, FL 33711 | 2016-03-08 |
| 1871966069 | Kelly Jean Plant | Home Health Aide | 3611 3rd Ave South, St Petersburg, FL 33711 | 2015-11-10 |
| 1750784815 | Honor Investments LLC | Community/Behavioral Health | 4750 Dophin Cay Ln S, #508, St Petersburg, FL 33711 | 2014-10-03 |
| 1063771947 | Vincent Ford | Physical Therapy Assistant | 3479 22nd Avenue, St.petersburg, FL 33711 | 2012-05-11 |
| 1568758571 | Ashley Lauren Taliaferro | Physical Therapist | 5042 42nd St S, Saint Petersburg, FL 33711 | 2011-06-28 |
| 1801180187 | Karen Lynn Wilcox | Massage Therapist | 2026 44th Street S, Saint Petersburg, FL 33711 | 2011-06-04 |
| 1881998722 | Martha L Allen | Assisted Living Facility | 1860 46 Street South, St. Petersburg, FL 33711 | 2011-01-07 |
| 1760519052 | Scg Palazzo Operator, LLC | Assisted Living Facility | 3600 34th St South, St Augustine, FL 33711 | 2007-02-27 |
| Find all providers in zip 33711 | ||||
| Taxonomy Code | 163WP0809X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114289261 | Debra Berard | Registered Nurse | 3820 Central Ave, St Petersburg, FL 33711-1237 | 2012-06-14 |
| 1851444343 | Nancy Wyatt | Registered Nurse | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2007-01-19 |
| 1306995097 | Darlene Ingrid Mclaughlin | Registered Nurse | 4024 Central Ave, St Petersburg, FL 33711-1239 | 2007-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871118380 | Alternative Psychiatry, LLC | Registered Nurse | 8788 Sr 70 E, Suite 101, Bradenton, FL 34202 | 2020-06-10 |
| 1588211734 | Marcello De Carvalho | Registered Nurse | 7801 Point Meadows Dr Unit 2310, Jacksonville, FL 32256-9142 | 2019-08-22 |
| 1326505017 | Jeanne Gynelle Wooden | Registered Nurse | 5665 Fort Rd, Greenwood, FL 32443-1969 | 2019-02-28 |
| 1184102006 | Kathleen Stewart | Registered Nurse | 2634 Capital Cir Ne Bldg G, Tallahassee, FL 32308-4106 | 2018-08-02 |
| 1326556069 | Rose Ledoux | Registered Nurse | 803 Fairmaiden Ln Apt 2, Brandon, FL 33511-5885 | 2018-01-16 |
| 1598116006 | Virginia Dohn | Registered Nurse | 8189 N Verdino Ter, Crystal River, FL 34428-6975 | 2016-06-27 |
| 1417305756 | Myrlene Merveille | Registered Nurse | 10330 Sw 20th Ct, Miramar, FL 33025-1776 | 2016-05-26 |
| 1255788832 | Jacqueline Ustache | Registered Nurse | 1647 Sun City Center Plz Ste 201, Sun City Center, FL 33573-5334 | 2016-05-24 |
| 1881902617 | Eric John Sebring | Registered Nurse | 5601 N Suwanee Ave, Tampa, FL 33604-7059 | 2010-09-14 |
| 1750614780 | Ewa Elzbieta Owens | Registered Nurse | 3000 41st St Ocean, Guidance Clinic of The Middle Keys, Marathon, FL 33050 | 2009-09-09 |
| Find all providers with the same taxonomy | ||||
| City | ST PETERSBURG |
| Zip Code | 33711 |
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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.