PHYSICIANS GROUP SERVICES PA (NPI# 1598033805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598033805 |
| Entity Type | Organization |
| Organization Name | PHYSICIANS GROUP SERVICES PA |
| Other Organization Name | KIDNEY CLINICS OF JACKSONVILLE |
| Practice Address |
14540 Old Saint Augustine Rd Ste 2397 Jacksonville FL 32258-7418 |
| Mailing Address |
7855 Argyle Forest Blvd Ste 101 Jacksonville FL 32244-5597 |
| Practice Telephone | 9042960670 |
| Practice Fax Number | 9042960698 |
| Mailing Telephone | 9042826331 |
| Mailing Fax Number | 9046191080 |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2020-07-29 |
| Authorized Official Name | ZANDA M CHANDLER (VICE PRESIDENT FINANCE) |
| Authorized Official Telephone | 9042826331 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 259123500 | 05 |
| Other Name | Type Code |
|---|---|
| Kidney Clinics of Jacksonville | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841674314 | Physicians Group Services Pa | Pediatrics | 421 Kingsley Ave Ste 300, Orange Park, FL 32073-4898 | 2015-07-15 |
| 1861440810 | Physicians Group Services Pa | Nurse Practitioner | 3839 County Road 218, Middleburg, FL 32068-5708 | 2006-05-04 |
| 1932682986 | Physicians Group Services Pa | Clinic/Center | 421 Kingsley Ave Ste 400, Orange Park, FL 32073-4898 | 2018-09-14 |
| 1497118160 | Physicians Group Services Pa | Family Medicine | 14810 Old Saint Augustine Rd, Suite 207, Jacksonville, FL 32258-2451 | 2016-03-31 |
| 1699138362 | Physicians Group Services Pa | Family Medicine | 1689 Eagle Harbor Pkwy, Suite A, Fleming Island, FL 32003-4817 | 2016-03-31 |
| 1962860619 | Physicians Group Services Pa | Podiatrist | 3839 County Road 218, Middleburg, FL 32068-5708 | 2016-02-09 |
| 1952706368 | Physicians Group Services Pa | Family Medicine | 2700 Riverside Ave, Suite 2, Jacksonville, FL 32205-8275 | 2014-10-28 |
| 1699170035 | Physicians Group Services Pa | Family Medicine | 13241 Bartram Park Blvd, Suite 1101, Jacksonville, FL 32258-5212 | 2014-10-28 |
| 1831530658 | Physicians Group Services Pa | Family Medicine | 421 Kingsley Ave, Orange Park, FL 32073-4897 | 2013-07-09 |
| 1598105686 | Physicians Group Services Pa | Family Medicine | 6816 Southpoint Pkwy, Suite 102, Jacksonville, FL 32216-1700 | 2013-07-03 |
| Street Address |
14540 OLD SAINT AUGUSTINE RD STE 2397 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32258-7418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912975236 | Kadir Mansur | Internal Medicine | 14540 Old Saint Augustine Rd Ste 2397, Jacksonville, FL 32258 | 2006-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437794237 | Nicoleta Descalzo | Behavior Technician | 12724 Grand Bay Parkway West, Suite 410, Jacksonville, FL 32258 | 2019-11-15 |
| 1992275572 | William Lundgren | Nurse Anesthetist, Certified Registered | 3625 University Blvd South, Jacksonville, FL 32258 | 2018-11-27 |
| 1104301159 | Emergency Physicians Inc | Emergency Medicine | 14534 Old St Augustine Rd, Suite 3110, Jacksonville, FL 32258 | 2018-09-26 |
| 1679092886 | Palm Life Medical Associates Pa | Assisted Living Facility | 12494 Acosta Oaks Drive, Jacksonville, FL 32258 | 2017-09-19 |
| 1679013932 | Optometry Vision Care Pllc | Optometrist | 14866 Old St. Augustine Rd Unit 110, Jacksonville, FL 32258 | 2017-03-06 |
| 1467991950 | North Florida Vision Group Inc | Optometrist | 14866 Old St. Augustine Rd., Suite 110, Jacksonville, FL 32258 | 2017-02-16 |
| 1124576566 | Revolution Chiropractic LLC | Chiropractor | 14866 Old St Augustine Road, Suite 113, Jacksonville, FL 32258 | 2016-09-14 |
| 1396291936 | Robyn Reaves | Nurse Practitioner | 12361 Richards Glen Ct, Jacksonville, FL 32258 | 2016-09-01 |
| 1326595927 | Lauren Cost | Chiropractor | 14866 Old St. Augustine Road, Suite 113, Jacksonville, FL 32258 | 2016-09-01 |
| 1487991170 | Mark Steven Colosimo | Pharmacist | 13820 Old St Augustine Road, Jacksonville, FL 32258 | 2013-01-15 |
| Find all providers in zip 32258 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629499090 | Pro-med Collectors LLC | Internal Medicine | 1907 Atlantic Blvd, Jacksonville, FL 32207-3466 | 2014-01-02 |
| 1821275330 | Nephrology Consultants of Jacksonville LLC | Internal Medicine | 3129 Hendricks Ave, Jacksonville, FL 32207-4217 | 2008-01-28 |
| 1457455719 | Andrew Wasiluk | Internal Medicine | 3129 Hendricks Avenue, Jacksonville, FL 32207-4217 | 2006-09-08 |
| 1811924210 | Naeem Haider | Internal Medicine | 3599 University Blvd So, Suite 805, Jacksonville, FL 32216 | 2006-06-28 |
| 1265474209 | Koithara Varkey Thomas | Internal Medicine | Eastern Nephrology Associates, 277 Memorial Drive, Jacksonville, NC 28546-6333 | 2006-06-12 |
| 1457917304 | Cardiorenal Therapeutics LLC | Internal Medicine | 6817 Southpoint Pkwy Ste 203, Jacksonville, FL 32216-6286 | 2019-05-16 |
| 1619434586 | Md. Irtiza Hasan | Internal Medicine | 655 W 8th St Fl 4, Jacksonville, FL 32209-6511 | 2019-02-26 |
| 1578058939 | Nephrology Consultants of Jacksonville LLC | Internal Medicine | 3129 Hendricks Ave, Jacksonville, FL 32207-4217 | 2018-06-28 |
| 1396283628 | A Abdalla, Inc | Internal Medicine | 5685 Norwood Ave, Jacksonville, FL 32208-5012 | 2017-02-07 |
| 1982141412 | Universal Kidney Care LLC | Internal Medicine | 10752 Deerwood Park Blvd Ste 100, Jacksonville, FL 32256-4846 | 2017-01-23 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32258 |
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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.