DR. BRUCE MITCHELL YERGIN (NPI# 1619962230) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619962230 |
| Entity Type | Individual |
| Full Name | DR. BRUCE MITCHELL YERGIN |
| Credential | M.D. |
| Practice Address |
3627 University Blvd S Ste 300 Jacksonville FL 32216 |
| Mailing Address |
8773 Perimeter Park Ct Jacksonville FL 32216-1165 |
| Practice Telephone | 9043960300 |
| Practice Fax Number | 9043963039 |
| Mailing Telephone | 9044933390 |
| Mailing Fax Number | 9044933395 |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2018-08-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
ME0021067 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | FL MEDICAID - GROUP | 0098365-00 | 01 |
| FL | AETNA | 5362087 | 01 |
| FL | AVMED | 215889 | 01 |
| FL | BLUE CROSS BLUE SHIELD | 78027 | 01 |
| FL | MEDICARE - GROUP | GR172A | 01 |
| FL | RR MEDICARE | PO1615058 | 01 |
| FL | 0141594-00 | 05 |
| Street Address |
3627 UNIVERSITY BLVD S STE 300 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962468892 | Paul Andrew Coley Jr. | Internal Medicine | 3627 University Blvd S Ste 300, Jacksonville, FL 32216 | 2006-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| 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 |
|---|---|---|---|---|
| 1376974485 | Gottskalk Bjornsson | Internal Medicine | 363 Creedmoor Rd, Jacksonville, NC 28546-6035 | 2013-11-29 |
| 1275890402 | Amit K Babbar | Internal Medicine | 1325 San Marco Blvd Ste 300, Jacksonville, FL 32207-8567 | 2012-04-12 |
| 1902178254 | Dennis J Mcdonagh M D P A | Internal Medicine | 2636 Forest Cir, Jacksonville, FL 32257-5612 | 2012-02-02 |
| 1386891042 | Leo F Black | Internal Medicine | 8244 Shady Grove Rd, Jacksonville, FL 32256-7361 | 2008-08-25 |
| 1376744581 | Margaret Davis Hovda | Internal Medicine | 425 North Lee Street, Suite 203, Jacksonville, FL 32204-1128 | 2007-05-29 |
| 1598781643 | Daniel S Wyzan | Internal Medicine | 425 North Lee St, Suite 203, Jacksonville, FL 32204-1128 | 2006-07-14 |
| 1649782392 | Emed Urgent and Primary Care Pa | Internal Medicine | 2624 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| 1750764668 | David Abia Trujillo | Internal Medicine | 4500 San Pablo Rd S, Jacksonville, FL 32224 | 2015-07-09 |
| 1326433624 | Scott Richard Steinberg | Internal Medicine | 655 W 8th St, Jacksonville, FL 32209-6511 | 2015-04-02 |
| 1134547250 | Hassan Baig | Internal Medicine | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2014-04-05 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
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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.