MR. SAMUEL SMALL I (NPI# 1568914174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568914174 |
| Entity Type | Individual |
| Full Name | MR. SAMUEL SMALL I |
| Practice Address |
3606 Jacob Lois Dr Jacksonville FL 32218-2970 |
| Practice Telephone | 9044831870 |
| Enumeration Date | 2016-10-30 |
| Last Update Date | 2016-10-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851952162 | Samuel Small | Nurse Practitioner | 1200 N Beaver St, Flagstaff, AZ 86001-3118 | 2019-06-26 |
| 1992761894 | Samuel D Small | Orthopaedic Surgery | 168 N Brent St, 505, Ventura, CA 93003-2817 | 2006-04-21 |
| Street Address |
3606 JACOB LOIS DR |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32218-2970 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578942520 | Bernadette Evelyenna Fields I | Social Worker | 3606 Jacob Lois Dr, Jacksonville, FL 32218-2970 | 2015-05-22 |
| 1689126898 | Pamela Ross | Community/Behavioral Health | 3606 Jacob Lois Dr, Jacksonville, FL 32218-2970 | 2016-11-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684170 | Damon Lamar Baker | Nurse Practitioner | 12533 Sampson Rd, Jacksonville, Fl, FL 32218 | 2020-09-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1932679594 | Alaina Rachelle Stanley | Counselor | 11683 Spring Board Dr, Jacksonville, FL 32218 | 2018-11-27 |
| 1508345133 | War Cry Ministry Inc | Counselor | 435 Eric Ave, Jacksonville, FL 32218 | 2018-08-14 |
| 1285111484 | St Vincent's Full Service Urgent Care, LLC | Clinic/Center | 15510 Max Leggett Parkway, Ste A, Jacksonville, FL 32218 | 2018-07-20 |
| 1427544501 | Derrick Roberts | Behavioral Analyst | 11302 Forestdale Rd, Jacksonville, FL 32218 | 2018-07-02 |
| 1215420229 | Companion & Compassion LLC | Home Health | 856 Poydras Ln W, Jacksonville, FL 32218 | 2018-06-13 |
| 1952894784 | Michael Alexander Aaro | Dentist | 1840 Dunn Ave Ste 3, Jacksonville, FL 32218 | 2018-06-06 |
| 1235629445 | Melissa C Moree | Counselor | 13453 Main St. North, Suite 104, Jacksonville, FL 32218 | 2018-05-14 |
| 1861900896 | Sheila Nowlin | Physical Therapist | 1034 Dunn Ave, Jacksonville, FL 32218 | 2018-01-11 |
| Find all providers in zip 32218 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427632 | Sunzup Counseling and Wellness | Community/Behavioral Health | 3355 Claire Ln Apt 1116, Jacksonville, FL 32223-6662 | 2020-11-02 |
| 1063043420 | Elephant Clinic Ltd. | Community/Behavioral Health | 8 Unf Dr # 221, Jacksonville, FL 32224-7699 | 2020-02-03 |
| 1679056857 | Inspire To Rise Inc. | Community/Behavioral Health | 4603 Silverthorn Dr, Jacksonville, FL 32258-2010 | 2018-09-13 |
| 1558863787 | Positive Development, LLC | Community/Behavioral Health | 3840 Belfort Rd Ste 302, Jacksonville, FL 32216-8210 | 2018-03-04 |
| 1073012555 | Pivotal Step Services, Pllc | Community/Behavioral Health | 1106b Gum Branch Rd, Jacksonville, NC 28540-5743 | 2018-02-09 |
| 1518473594 | Werp LLC | Community/Behavioral Health | 5291 Collins Rd Lot 293, Jacksonville, FL 32244-5389 | 2017-12-28 |
| 1871007062 | National Youth Advocate Program, Inc | Community/Behavioral Health | 2200 Rosselle St, Jacksonville, FL 32204-3126 | 2017-11-27 |
| 1962913327 | Port Health Services | Community/Behavioral Health | 224 Memorial Dr Ste B, Jacksonville, NC 28546-6332 | 2017-10-12 |
| 1598282667 | B.e.h. Elderly Care LLC | Community/Behavioral Health | 5145 Timuquana Rd Apt 6, Jacksonville, FL 32210-8923 | 2017-08-29 |
| 1427598689 | Family Farms of Northeast Florida | Community/Behavioral Health | 16844 Ethel Rd, Jacksonville, FL 32218-1108 | 2017-03-06 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32218 |
Please comment or provide details below to improve the information on MR. SAMUEL SMALL I.
| 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.