MR. MICHAEL DARREN WENDT (NPI# 1609173236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609173236 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL DARREN WENDT |
| Credential | PA |
| Practice Address |
9857 Old Saint Augustine Rd Jacksonville FL 32257-8853 |
| Mailing Address |
2270 Club Lake Dr Orange Park FL 32065-2645 |
| Practice Telephone | 9048611900 |
| Mailing Telephone | 7012008964 |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2020-07-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9112985 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2d Lar, Psc Box 20090, Camp Lejeune, NC 28542 | 9104514396 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144686973 | Michael Ronald Wendt | Counselor | W6144 Aerotech Dr, Appleton, WI 54914-7503 | 2016-01-08 |
| 1164706073 | Michael Thomas Wendt | Physician Assistant | 38935 Ann Arbor Road, Professional Emergency Care, PC, Livonia, MI 48150-3397 | 2011-10-11 |
| 1407877129 | Michael L Wendt | Pharmacist | 13000 Bruce B Downs Blvd, Tampa, FL 33612-4745 | 2006-07-21 |
| 1467429779 | Michael O. Wendt | Anesthesiology | 5 Richland Medical Park, Columbia, SC 29203-8000 | 2006-03-06 |
| Street Address |
9857 OLD SAINT AUGUSTINE RD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32257-8853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366599540 | Majed B Hassan | Family Medicine | 9857 Old Saint Augustine Rd, Suite 1, Jacksonville, FL 32257-8853 | 2007-01-03 |
| 1952648396 | River City Pediatric Dentistry, P.a. | Clinic/Center | 9857 Old Saint Augustine Rd, Suite 3, Jacksonville, FL 32257-8853 | 2013-01-04 |
| 1891931267 | Maria Vanessa Comia Salvador | Specialist | 9857 Old Saint Augustine Rd, Suite 6, Jacksonville, FL 32257-8853 | 2009-01-06 |
| 1386891778 | Maureen O'brien | Family Medicine | 9857 Old Saint Augustine Rd, Jacksonville, FL 32257-8853 | 2008-08-27 |
| 1780737197 | Grace Merchant | Nurse Practitioner | 9857 Old Saint Augustine Rd, Jacksonville, FL 32257-8853 | 2007-01-19 |
| 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 | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851919526 | Kyra Panni | Physician Assistant | 3857 Hartwood Ln, Jacksonville, FL 32216-1486 | 2020-07-09 |
| 1467935213 | Alexis Almonte | Physician Assistant | 655 W 8th St # C-3, Jacksonville, FL 32209-6511 | 2018-09-07 |
| 1053851535 | Luciana Oran | Physician Assistant | 4849 Florida Club Cir Apt 3104, Jacksonville, FL 32216-1089 | 2017-03-02 |
| 1699217463 | Ashley C Moyer | Physician Assistant | 5742 Booth Rd Ste A, Jacksonville, FL 32207-5982 | 2016-11-10 |
| 1437600889 | Lindsay Elizabeth Murrell | Physician Assistant | 14540 Old Saint Augustine Rd Ste 2599, Jacksonville, FL 32258-7420 | 2016-10-20 |
| 1992178719 | Sonila Musta-kina | Physician Assistant | 1633 Race Track Rd Ste 101, Jacksonville, FL 32259-3237 | 2015-11-02 |
| 1922409580 | Lindsey Beth Hollingsworth | Physician Assistant | 841 Prudential Dr Ste 1900, Jacksonville, FL 32207-8373 | 2014-09-12 |
| 1487905220 | Krystin Michelle Greene | Physician Assistant | 4085 University Blvd S Ste 3, Jacksonville, FL 32216-4362 | 2012-09-19 |
| 1790034296 | Gary Robertson | Physician Assistant | 12964 Winthrop Cove Dr, Jacksonville, FL 32224-7503 | 2012-08-30 |
| 1366711905 | Jeremiah Taejong Oh | Physician Assistant | 3d Battalion, 8th Marines Psc Box 20104, Camp Lejeune, Jacksonville, NC 28542-0104 | 2011-12-28 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32257 |
Please comment or provide details below to improve the information on MR. MICHAEL DARREN WENDT.
| 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.