FAMILY PRACTICE OF JACKSONVILLE PC (NPI# 1568571602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568571602 |
| Entity Type | Organization |
| Organization Name | FAMILY PRACTICE OF JACKSONVILLE PC |
| Practice Address |
1881 Hwy 21 South Jacksonville AL 36265 |
| Mailing Address |
Po Box 777 1881 Hwy 21 South Jacksonville AL 36265 |
| Practice Telephone | 2564353035 |
| Practice Fax Number | 2564359111 |
| Mailing Telephone | 2564353035 |
| Mailing Fax Number | 2564359111 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2008-04-22 |
| Authorized Official Name | KEWAL K VERMA (PRESIDENT) |
| Authorized Official Telephone | 2564353035 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 7306 | AL | Allopathic & Osteopathic Physicians |
| Y | 207K00000X | Allergy & Immunology | 7306 | AL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CLIA | 01D0689490 | 01 |
| Street Address |
1881 HWY 21 SOUTH |
| City | JACKSONVILLE |
| State | AL |
| Zip Code | 36265 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700436144 | Griffin Loflin | Specialist/Technologist | 775 Park Ave Nw, Attn. Sports Medicine, Jacksonville, AL 36265 | 2019-09-17 |
| 1114304011 | Caroline Ross | Counselor | 1215 Jackson Way Sw, Jacksonville, AL 36265 | 2015-04-29 |
| 1083001226 | Tracey Hudgins | Counselor | 1215 Jackson's Way, Jacksonville, AL 36265 | 2015-04-24 |
| 1235415118 | Adam Pike | Pharmacist | 311 Pelham Rd So, Jacksonville, AL 36265 | 2011-10-24 |
| 1386829489 | Physicians Choice Dialysis of Jacksonville, LLC | Clinic/Center | 331 Henry Road Sw, Jacksonville, AL 36265 | 2008-01-08 |
| 1659409365 | Kenneth Wayne Campbell | Nurse Anesthetist, Certified Registered | 1701 Pelham Road, Jacksonville Medical Center, Jacksonville, AL 36265 | 2007-03-02 |
| 1154478378 | Diana C. Ford | Counselor | 1250 Jackson's Way, Garrett Counseling Center, Jacksonville, AL 36265 | 2007-01-03 |
| 1487710950 | James Richard Morrison | Chiropractor | 1550 Pelham Rd. S., Jacksonville, AL 36265 | 2006-12-29 |
| 1447332937 | Millennium Anesthesia Services | Anesthesiology | 1701 Pelham Road S, Jacksonville, AL 36265 | 2006-10-20 |
| 1407943228 | Brunda Revanna, Md | Clinic/Center | 1465 A 1st Ave Sw Ste C, Jacksonville, AL 36265 | 2006-10-05 |
| Find all providers in zip 36265 | ||||
| Taxonomy Code | 207K00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Selected examples of such conditions include asthma, anaphylaxis, rhinitis, eczema, and adverse reactions to drugs, foods, and insect stings as well as immune deficiency diseases (both acquired and congenital), defects in host defense, and problems related to autoimmune disease, organ transplantation, or malignancies of the immune system. |
| Notes: Source: American Board of Medical Specialties, 2007, www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Allergy and Immunology, 2007. http://www.abai.org/ No subspecialty certificates in allergy and immunology are offered by the American Board of Allergy and Immunology (ABAI). The ABAI, however, does offer formal special pathways for physicians seeking dual certification in allergy/immunology and pediatric pulmonology; allergy/immunology and pediatric rheumatology; and allergy/immunology and adult rheumatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356367650 | Tracy A Sinha-khona | Allergy & Immunology | 4131 University Blvd S Ste 4a, Jacksonville, FL 32216-4322 | 2006-07-14 |
| 1578517009 | Sanjay Swami | Allergy & Immunology | 9191 R G Skinner Parkway, Suite 402, Jacksonville, FL 32256-9179 | 2006-05-20 |
| 1083668511 | First Coast Allergy and Asthma Pa | Allergy & Immunology | 9191 R.g. Skinner Parkway, Suite 402, Jacksonville, FL 32256-9179 | 2006-05-20 |
| 1255394896 | Allen Okie | Allergy & Immunology | 2345 Park St, Jacksonville, FL 32204-4317 | 2006-04-06 |
| 1497749071 | Sudhir L Prabhu | Allergy & Immunology | 4123 University Blvd S, B, Jacksonville, FL 32216-4371 | 2005-09-09 |
| 1306830989 | Paul F Wubbena Jr | Allergy & Immunology | 11267 Harbour Woods Rd S, Jacksonville, FL 32225-1504 | 2005-09-09 |
| 1902344427 | Raquel S Watkins Md Pllc | Allergy & Immunology | 13241 Bartram Park Blvd, Suite 2601, Jacksonville, FL 32258-5212 | 2017-02-03 |
| 1346555307 | Allen Okie Md Pa | Allergy & Immunology | 2345 Park St, Jacksonville, FL 32204-4317 | 2010-08-15 |
| 1982921169 | Alexei Gonzalez Estrada | Allergy & Immunology | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2010-04-27 |
| 1124283544 | Chitra Kuthiala Md Pa | Allergy & Immunology | 9765 San Jose Blvd, Suite 108, Jacksonville, FL 32257-4402 | 2008-07-24 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 36265 |
Please comment or provide details below to improve the information on FAMILY PRACTICE OF JACKSONVILLE PC.
| 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.