RIVERSIDE SPINE & PAIN PHYSICIANS, LLC (NPI# 1639208648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639208648 |
| Entity Type | Organization |
| Organization Name | RIVERSIDE SPINE & PAIN PHYSICIANS, LLC |
| Practice Address |
7207 Golden Wings Road Suite 100 Jacksonville FL 32244-2004 |
| Mailing Address |
6195 Lake Gray Blvd Suite 4 Jacksonville FL 32244-5891 |
| Practice Telephone | 9043891010 |
| Practice Fax Number | 9043891082 |
| Mailing Telephone | 9043891010 |
| Mailing Fax Number | 9043891082 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2019-10-14 |
| Authorized Official Name | DR. JENNIFER B BALDOCK (OFFICER AND AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 6152345900 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | ME83572 | FL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS BLUE SHIELD | 34167 | 01 |
| FL | AETNA | 2947648 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982070140 | Riverside Spine & Pain Physicians, LLC | Specialist | 13133 Professional Dr, Suite 200, Jacksonville, FL 32225-7122 | 2015-08-11 |
| 1477922920 | Riverside Spine & Pain Physicians, LLC | Specialist | 2453 Us Highway 17, Suite G, Richmond Hill, GA 31324-5959 | 2015-09-15 |
| 1124494398 | Riverside Spine & Pain Physicians, LLC | Specialist | 7751 Baymeadows Rd E, Suite 103, Jacksonville, FL 32256-5836 | 2015-08-11 |
| 1669848834 | Riverside Spine & Pain Physicians, LLC | Specialist | 2386 Dunn Ave, Suite 111, Jacksonville, FL 32218-4750 | 2015-08-11 |
| 1659747822 | Riverside Spine & Pain Physicians, LLC | Specialist | 1577 Roberts Dr, Suite 326, Jacksonville Beach, FL 32250-3264 | 2015-08-11 |
| 1649646811 | Riverside Spine & Pain Physicians, LLC | Specialist | 2349 Village Square Pkwy, Suite 107, Fleming Island, FL 32003-6355 | 2015-08-11 |
| 1619343886 | Riverside Spine & Pain Physicians, LLC | Specialist | 12078 San Jose Blvd, Suite 2, Jacksonville, FL 32223-8670 | 2015-08-11 |
| 1710353982 | Riverside Spine & Pain Physicians, LLC | Specialist | 105 Mariner Health Way, Unit 203, St Augustine, FL 32086-3251 | 2015-08-11 |
| 1982070157 | Riverside Spine & Pain Physicians, LLC | Specialist | 3622 Madaca Ln, Tampa, FL 33618-2057 | 2015-08-11 |
| Street Address |
7207 GOLDEN WINGS ROAD SUITE 100 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32244-2004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194722512 | Craig Allen Kornick | Pain Medicine | 7207 Golden Wings Road, Jacksonville, FL 32244 | 2005-06-30 |
| 1548594880 | Riverside Surgical Center | Clinic/Center | 7207 Golden Wings Road, Suite 200, Jacksonville, FL 32244 | 2009-09-18 |
| 1265672356 | Riverside Surgical Center,llc | Clinic/Center | 7207 Golden Wings Road, Suite 200, Jacksonville, FL 32244-0000 | 2009-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013478247 | Saul Medina | Contractor | 8421 Cheswick Oak Ave, Jacksonville, FL 32244 | 2019-03-29 |
| 1447765748 | Sudduth Vision Pllc | Optometrist | 8000 Parramore Rd., Jacksonville, FL 32244 | 2017-12-08 |
| 1144735556 | Costco Wholesale Corporation | Pharmacy | 8000 Parramore Rd, Jacksonville, FL 32244 | 2017-12-07 |
| 1003287814 | South Jacksonville Dental Pllc | Dentist | 8440 Blanding Blvd, Jacksonville, FL 32244 | 2015-10-20 |
| 1326444340 | Laurie Lynn Scheid | Nurse Practitioner | 7855 Argyle Forest Blvd Ste 601, Jacksonville, FL 32244 | 2014-11-18 |
| 1114322260 | Candy Sharon Lucero | Occupational Therapist | 8563-2 Argyle Business Loop, Jacksonville, FL 32244 | 2014-10-31 |
| 1780959817 | Senior Helpers | In Home Supportive Care | 6327 Argyle Forest Blvd, Suite 3, Jacksonville, FL 32244 | 2012-03-22 |
| 1093831505 | Eduardo R Paat Sr. | Marriage & Family Therapist | 63394 Argyle Forest Blvd, Jacksonville, FL 32244 | 2007-03-22 |
| 1760524060 | Lauren Claxton Shivers | Nurse Practitioner | 8351 Westport Road, Jacksonville, FL 32244 | 2007-02-13 |
| 1427113968 | John F Bibb | Dentist | 6001 4 Argyle Forest Blvd, Jacksonville, FL 32244 | 2006-12-26 |
| Find all providers in zip 32244 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437768033 | Coastal Injury Clinic LLC | Specialist | 2700 Riverside Ave Ste 1, Jacksonville, FL 32205-8233 | 2020-07-29 |
| 1255957643 | Rhonda D Smith Roberts | Specialist | 2754 Sam Hardwick Blvd, Jacksonville, FL 32246-3892 | 2020-06-22 |
| 1437620986 | Nicole Azaan | Specialist | 2301 Indian Dr Apt 29c, Jacksonville, NC 28546-5258 | 2018-12-10 |
| 1598251910 | Allionz LLC | Specialist | 2386 Dunn Ave Ste 109, Jacksonville, FL 32218-4751 | 2018-07-09 |
| 1093236531 | Leah F Friedman | Specialist | 1650 Prudential Dr Ste 102, Jacksonville, FL 32207-8148 | 2017-07-06 |
| 1609301993 | Oakleaf Injury and Pain Center LLC | Specialist | 9526 Argyle Forest Blvd, B-6, Jacksonville, FL 32222-2825 | 2017-04-25 |
| 1982070140 | Riverside Spine & Pain Physicians, LLC | Specialist | 13133 Professional Dr, Suite 200, Jacksonville, FL 32225-7122 | 2015-08-11 |
| 1235525239 | Elizabeth Wehr | Specialist | 319 1st Ave N Apt 1a, Jacksonville, FL 32250-5500 | 2015-04-07 |
| 1053705236 | Orthowilmington, Pa | Specialist | 3382 Henderson Dr, Jacksonville, NC 28546-5230 | 2015-03-25 |
| 1295156941 | Southeast Orthopedic Specialists, Inc. | Specialist | 10475 Centurion Pkwy N Ste 220, Jacksonville, FL 32256-5004 | 2013-12-26 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32244 |
Please comment or provide details below to improve the information on RIVERSIDE SPINE & PAIN PHYSICIANS, LLC.
| 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.