EMERGENCY MEDICAL SPECIALISTS OF JACKSONVILLE (NPI# 1295738367) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295738367 |
| Entity Type | Organization |
| Organization Name | EMERGENCY MEDICAL SPECIALISTS OF JACKSONVILLE |
| Practice Address |
1 Shircliff Way Jacksonville FL 32204-4778 |
| Mailing Address |
Po Box 863026 Orlando FL 32886-3026 |
| Practice Telephone | 9043087300 |
| Practice Fax Number | 4198665453 |
| Mailing Telephone | 8002888325 |
| Mailing Fax Number | 4198665453 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2013-02-19 |
| Authorized Official Name | DR. PAUL LUCEY (PARTNER) |
| Authorized Official Telephone | 9043087300 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS GROUP NUM | 99356 | 01 |
| FL | 038371600 | 05 |
| Street Address |
1 SHIRCLIFF WAY |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-4778 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033725858 | Kathleen Fry | Registered Nurse | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2020-09-17 |
| 1841808912 | Jade Leanne Nelson Donegal | Registered Nurse | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2020-07-15 |
| 1124642731 | Arielle Christina Griffin | Social Worker | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2020-05-31 |
| 1639709199 | Tom Wonneberger | Physician Assistant | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2020-01-23 |
| 1114557162 | Janet Marie Goodson | Registered Nurse | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2020-01-17 |
| 1487291472 | Megan Elaine Karbowski | Anesthesiologist Assistant | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2019-12-09 |
| 1124663182 | Douglas Earl Stilwell | Nurse Practitioner | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2019-11-14 |
| 1316588908 | Andrew Griffin | Anesthesiologist Assistant | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2019-10-04 |
| 1194366278 | Laura Ann Kereczman | Nurse Practitioner | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2019-09-30 |
| 1942859251 | Christine Katherine O'reilly | Anesthesiologist Assistant | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2019-09-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427690353 | Emergency Physicians Inc | Emergency Medicine | 9868 Family Place, Jacksonville, FL 32222 | 2019-10-11 |
| 1104301159 | Emergency Physicians Inc | Emergency Medicine | 14534 Old St Augustine Rd, Suite 3110, Jacksonville, FL 32258 | 2018-09-26 |
| 1922525229 | Dwic of Tampa Bay, Inc | Emergency Medicine | 11985 Atlantic Boulevard, Jacksonville, FL 32225-2919 | 2017-08-28 |
| 1063945541 | Hassan Mohammad Aboudan | Emergency Medicine | 8455 Stables Rd, Jacksonville, FL 32256-7265 | 2017-04-11 |
| 1639626476 | Emergency Physicians Inc | Emergency Medicine | 11250 Baptist Health Drive, Suite 713, Jacksonville, FL 32218 | 2016-09-09 |
| 1497107957 | Frank Rodriguez | Emergency Medicine | 7615 Hunters Grove Rd, Jacksonville, FL 32256-7210 | 2016-07-08 |
| 1649631391 | Emergency Physicians Inc | Emergency Medicine | 4085 Town Center Pkwy, Jacksonville, FL 32246-8580 | 2016-03-09 |
| 1619387099 | John Michael Kiel | Emergency Medicine | Department of Emergency Medicine, 125 Floor Clinical Ce, 655 West 8th Street, C506, Jacksonville, FL 32209-3220 | 2014-05-06 |
| 1225455306 | James Esser Barr | Emergency Medicine | 653 W 8th St # L15, Jacksonville, FL 32209-6511 | 2014-03-26 |
| 1992122170 | Nadia Bakor | Emergency Medicine | 6477 103rd St, Jacksonville, FL 32210-7129 | 2014-03-25 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
Please comment or provide details below to improve the information on EMERGENCY MEDICAL SPECIALISTS OF JACKSONVILLE.
| 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.