DR. JERRY L WAIKINS (NPI# 1629032974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629032974 |
| Entity Type | Individual |
| Full Name | DR. JERRY L WAIKINS |
| Credential | M.D. |
| Practice Address |
120 Cypress Edge Dr Ste 102 Palm Coast FL 32164-8454 |
| Mailing Address |
117 Meadowbrook Cir Daytona Beach FL 32114-1164 |
| Mailing Telephone | 3864923243 |
| Mailing Fax Number | 3864923243 |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2020-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | ME19703 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
120 CYPRESS EDGE DR STE 102 |
| City | PALM COAST |
| State | FL |
| Zip Code | 32164-8454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114329729 | Kate Loftis | Physician Assistant | 120 Cypress Edge Dr Ste 102, Palm Coast, FL 32164-8454 | 2014-09-25 |
| 1144575002 | Asfar Mushtaq | Family Medicine | 120 Cypress Edge Dr Ste 102, Palm Coast, FL 32164-8454 | 2012-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417561044 | Ereka Manangan | Pharmacist | 5000 E, Fl-100, Palm Coast, FL 32164 | 2020-09-01 |
| 1427661735 | George Allen Parker | Pharmacist | 5000 E Hwy 100, Palm Coast, FL 32164 | 2020-08-26 |
| 1891318424 | Faithangel Corp | In Home Supportive Care | 125 Pine Grove Dr, Palm Coast, FL 32164 | 2020-05-18 |
| 1578101481 | Sweetie Peetie LLC | Hearing Instrument Specialist | 160 Cypress Point Parkway, Ste A108, Palm Coast, FL 32164 | 2019-12-11 |
| 1831656610 | Dolphin Medical Transport LLC | Taxi | 30 Westmoreland Dr, Palm Coast, FL 32164 | 2019-02-27 |
| 1003389024 | Southeast Snoring & Sleep Apnea Group | Durable Medical Equipment & Medical Supplies | 108 Pennacles Dr. #101, Palm Coast, FL 32164 | 2019-01-03 |
| 1801388137 | Lily Michelle King | Licensed Practical Nurse | 8 Regent Ln, Palm Coast, FL 32164 | 2018-06-01 |
| 1558880120 | Bryan Mendes | Physical Therapist | 1 Westrock Ln, Palm Coast, FL 32164 | 2017-09-14 |
| 1477077451 | Sharon Denise Astrologo | Case Manager/Care Coordinator | 421 S. Keech St., Daytona Beach, FL 32164 | 2017-08-01 |
| 1952825283 | Emily Guarino | Behavior Technician | 136a Wellwood Lane, Palm Coast, FL 32164 | 2017-07-28 |
| Find all providers in zip 32164 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508002395 | Yesenia E Justiniano Rosario | General Practice | 2 Mccormick Dr, Palm Coast, FL 32164-2352 | 2008-12-28 |
| 1780645903 | Alex Ramon Taveras-cruz | General Practice | 264a Palm Coast Pkwy Ne, Palm Coast, FL 32137-8217 | 2006-03-29 |
| 1053762740 | Coastal Healthcare Partners, LLC | General Practice | 50 Leanni Way, Suite D1, Palm Coast, FL 32137 | 2016-06-24 |
| 1831311810 | Palm Harbor Family Practice and Walk In Clinic Pa | General Practice | 9 Pine Cone Dr, Suite 102, Palm Coast, FL 32137-8686 | 2007-05-02 |
| 1225131477 | Ardent Family Care Pa | General Practice | 84 Pinnacles Dr Ste 200, Palm Coast, FL 32164-2324 | 2006-09-06 |
| 1124039409 | Rommelle Von Such | General Practice | 1 Florida Park Dr N, Suite 109-110, Palm Coast, FL 32137-3852 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033823 | Bless Medical Center of Nmb LLC | General Practice | 1400 Ne Miami Gardens Dr Ste 209, North Miami Beach, FL 33179-4844 | 2020-11-02 |
| 1982203634 | Central Florida Wellness LLC | General Practice | 15516 W Colonial Dr Ste 111, Winter Garden, FL 34787-9558 | 2020-10-23 |
| 1760080212 | Summit Health Multi Specialty of Florida LLC | General Practice | 1881 W Kennedy Blvd Ste D, Tampa, FL 33606-1611 | 2020-10-15 |
| 1376140772 | Amy Wrenn | General Practice | 155 Cranes Roost Blvd Ste 2020-a, Altamonte Springs, FL 32701-3468 | 2020-10-08 |
| 1992302574 | Avita Medical Clinic, LLC | General Practice | 14831 N Florida Ave, Tampa, FL 33613-1825 | 2020-10-06 |
| 1568069672 | Ernesto Oscar Gonzalez Pupo | General Practice | 14420 Sw 22nd St, Miami, FL 33175-6338 | 2020-10-02 |
| 1508463779 | Ashley Zanders Walton | General Practice | 75 Foxfire Ct, Quincy, FL 32351-7293 | 2020-10-01 |
| 1730796830 | Brid M Wade | General Practice | 3199 Cornell Dr, Gulf Breeze, FL 32563-2785 | 2020-09-23 |
| 1902412786 | New Era Medical Pllc | General Practice | 628 Cleveland St Ste A, Clearwater, FL 33755-6603 | 2020-09-17 |
| 1417562414 | Jl Laria Aprn Pa | General Practice | 5751a Sw 40th St, Miami, FL 33155-5301 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
| City | PALM COAST |
| Zip Code | 32164 |
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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.