MR. OWEN EDMOND MCDONOUGH JR. (NPI# 1316919236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316919236 |
| Entity Type | Individual |
| Full Name | MR. OWEN EDMOND MCDONOUGH JR. |
| Credential | PA |
| Practice Address |
9826 San Jose Blvd Jacksonville FL 32257-5438 |
| Mailing Address |
2908 Circle Ridge Dr Orange Park FL 32065-5760 |
| Practice Telephone | 9042629444 |
| Practice Fax Number | 9042922285 |
| Mailing Telephone | 9049937726 |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2010-11-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9103012 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
9826 SAN JOSE BLVD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32257-5438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497171565 | Michael Nguyen | Physician Assistant | 9826 San Jose Blvd, Jacksonville, FL 32257-5438 | 2014-03-12 |
| 1710110143 | Cortney L Keeley | Physician Assistant | 9826 San Jose Blvd, Jacksonville, FL 32257-5438 | 2009-09-02 |
| 1144469230 | Physicians Medical Centers-jax, Inc | Clinic/Center | 9826 San Jose Blvd, Jacksonville, FL 32257-5438 | 2009-02-12 |
| 1497909451 | Tamara Stowers Crowell | Physician Assistant | 9826 San Jose Blvd, Jacksonville, FL 32257-5438 | 2008-11-04 |
| 1902088461 | Physicians Medical Center-jax Inc | Clinic/Center | 9826 San Jose Blvd, Jacksonville, FL 32257-5438 | 2007-11-27 |
| 1972724144 | Barnes E Sale IIi | Physical Therapist | 9826 San Jose Blvd, Jacksonville, FL 32257-5438 | 2007-05-02 |
| 1063454858 | Physicians Medical Center, Inc. | Clinic/Center | 9826 San Jose Blvd, Jacksonville, FL 32257-5438 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740835842 | Majdoline Kasera | Pharmacist | 11250-4 Old St Augustine Rd, Jacksonville, FL 32257 | 2019-08-06 |
| 1386203859 | Jetaime Y Lewis | Physical Therapist | 9765 San Jose Blvd Ste 6, Jacksonville, FL 32257 | 2019-06-10 |
| 1437622107 | Michelle Espanol Garcia | Nurse Practitioner | 9957 Moorings Dr Ste 204, Jacksonville, FL 32257 | 2019-01-05 |
| 1982172995 | Pacifica Augustine Road LLC | Alzheimer Center (Dementia Center) | 10660 Old Augustine Road, Jacksonville, FL 32257 | 2018-11-07 |
| 1659860492 | Andrea Leigh Miller | Social Worker | 10416 Spotted Fawn Lane, Jacksonville, FL 32257 | 2018-05-08 |
| 1376049965 | Stephanie Lynne Jordon | Nurse Practitioner | 9765 San Jose Blvd Ste 102, Jacksonville, FL 32257 | 2018-04-02 |
| 1205335619 | Annetta Aileen Brown | Respite Care | 4901 Sunbeam Rd Apt 1016, Jacksonville, FL 32257 | 2018-02-12 |
| 1841714888 | Freda Stevens | Counselor | 9521 Shellie Road Unit 13, Jacksonville, FL 32257 | 2017-08-01 |
| 1659821353 | Jennifer Lavoro | Acupuncturist | 11259 Thomaston Pl, Jacksonville, FL 32257 | 2016-10-06 |
| 1225488232 | Avenues Dental LLC | Dentist | 6144 Gazebo Park Place South, Ste 210, Jacksonville, FL 32257 | 2016-06-21 |
| Find all providers in zip 32257 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831799527 | Emily Vander Zee | Physician Assistant | 6680 Bennett Creek Dr Apt 213, Jacksonville, FL 32216-0018 | 2020-10-30 |
| 1245830314 | Jonathan V Korah | Physician Assistant | 6650 Corporate Center Pkwy Apt 1108, Jacksonville, FL 32216-8725 | 2020-10-28 |
| 1255931473 | Rachel Gavrielle Stahly | Physician Assistant | 11438 Emuness Rd, Jacksonville, FL 32218-4050 | 2020-10-27 |
| 1760099071 | Laura Alexandra Ramos-heckman | Physician Assistant | 2014 Capistrano Dr, Jacksonville, FL 32224-3091 | 2020-09-30 |
| 1184230583 | Julian Clouse | Physician Assistant | 9803 Creekfront Rd Apt 307, Jacksonville, FL 32256-8449 | 2020-09-21 |
| 1962016717 | Stephanie Benton Gentry | Physician Assistant | 3179 Shadow Creek Rd, Jacksonville, FL 32226-2386 | 2020-08-31 |
| 1629689435 | Monarch Mental Health Association | Physician Assistant | 5393 Roosevelt Blvd Ste 8, Jacksonville, FL 32210-8424 | 2020-08-14 |
| 1235749425 | Nicole Lhommedieu | Physician Assistant | 3850 Marnie Pl, Jacksonville, FL 32223-3541 | 2020-08-03 |
| 1861002123 | Naw-am Acio Daniels | Physician Assistant | 7467 Volley Dr N, Jacksonville, FL 32277-9368 | 2020-08-03 |
| 1750906640 | Veronica Adriana Dediego | Physician Assistant | 915 W Monroe St Ste 300, Jacksonville, FL 32204-1177 | 2020-06-16 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32257 |
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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.