PETER KIMBALL (NPI# 1689009201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689009201 |
| Entity Type | Individual |
| Full Name | PETER KIMBALL |
| Credential | PA-C |
| Practice Address |
2401 Monument Rd Jacksonville FL 32225-2520 |
| Mailing Address |
4500 San Pablo Rd S Jacksonville FL 32224-1865 |
| Practice Telephone | 9046420337 |
| Mailing Telephone | 9049532000 |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2020-10-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9112110 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4500 San Pablo Rd S, Jacksonville, FL 322241865 | 9049532000 | |
| 4502 Medical Dr, San Antonio, TX 782294402 | 2103582078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023327400 | Peter Jeffers Kimball Jr. | Social Worker | 66 State St, Portland, ME 04101-3751 | 2010-10-01 |
| 1487831871 | Peter T Kimball | Dentist | 30190 Town Center Drive, Suite A, Laguna Niguel, CA 92677 | 2008-01-28 |
| Street Address |
2401 MONUMENT RD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32225-2520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457443632 | Eldon Dale Brandt | Family Medicine | 2401 Monument Rd, Jacksonville, FL 32225-2520 | 2006-09-28 |
| 1699148254 | Jenna Johnson Meng | Physician Assistant | 2401 Monument Rd, Jacksonville, FL 32225-2520 | 2015-11-04 |
| 1740610203 | Jenny Vuong Cooke | Physician Assistant | 2401 Monument Rd, Jacksonville, FL 32225-2520 | 2013-11-20 |
| 1952623639 | Solantic Urgent Care | Pharmacy | 2401 Monument Rd, Jacksonville, FL 32225-2520 | 2010-02-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700356367 | Ajay S Lewis | Counselor | 3010 Cobblewood Ln East, Jacksonville, FL 32225 | 2018-11-27 |
| 1467921569 | Heart To Heart LLC | Assisted Living Facility | 9378 Arlignton Expressway, Ste 218, Jacksonville, FL 32225 | 2018-11-19 |
| 1285122036 | National Vision, Inc. | Technician/Technologist | 11770 Atlantic Boulevard, Suite 300, Jacksonville, FL 32225 | 2018-04-27 |
| 1346757432 | Dedicated Senior Medical Center of Florida, LLC | Non-Pharmacy Dispensing Site | 9422 Arlington Expressway, Jacksonville, FL 32225 | 2018-01-10 |
| 1831629690 | Family First Vision Care, Pllc | Optometrist | 9398 Arlington Expresway, Suite 1, Jacksonville, FL 32225 | 2017-06-14 |
| 1437689205 | West Point Optical Group | Optometrist | 9398-1 Arlington Expresway, Jacksonville, FL 32225 | 2017-06-14 |
| 1477087815 | Naila Ortega | Dentist | 984 Chapeltown Circle N, Jacksonville, FL 32225 | 2017-04-12 |
| 1487186342 | Sidnetta Rosemond | Durable Medical Equipment & Medical Supplies | 9501 Arlington Expy Ste160, Jacksonville, FL 32225 | 2017-03-30 |
| 1669925913 | Frances Mcmiller | Counselor | 9550 Regency Square Blvd Ste 706, Jacksonville, FL 32225 | 2016-08-03 |
| 1891143103 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 1211 St. Johns Bluff Rd North, Jacksonville, FL 32225 | 2016-05-26 |
| Find all providers in zip 32225 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831799527 | Emily Vander Zee | Physician Assistant | 6680 Bennett Creek Dr Apt 213, Jacksonville, FL 32216-0018 | 2020-10-30 |
| 1245830314 | Jonathan V Korah | Physician Assistant | 6650 Corporate Center Pkwy Apt 1108, Jacksonville, FL 32216-8725 | 2020-10-28 |
| 1255931473 | Rachel Gavrielle Stahly | Physician Assistant | 11438 Emuness Rd, Jacksonville, FL 32218-4050 | 2020-10-27 |
| 1760099071 | Laura Alexandra Ramos-heckman | Physician Assistant | 2014 Capistrano Dr, Jacksonville, FL 32224-3091 | 2020-09-30 |
| 1184230583 | Julian Clouse | Physician Assistant | 9803 Creekfront Rd Apt 307, Jacksonville, FL 32256-8449 | 2020-09-21 |
| 1962016717 | Stephanie Benton Gentry | Physician Assistant | 3179 Shadow Creek Rd, Jacksonville, FL 32226-2386 | 2020-08-31 |
| 1629689435 | Monarch Mental Health Association | Physician Assistant | 5393 Roosevelt Blvd Ste 8, Jacksonville, FL 32210-8424 | 2020-08-14 |
| 1235749425 | Nicole Lhommedieu | Physician Assistant | 3850 Marnie Pl, Jacksonville, FL 32223-3541 | 2020-08-03 |
| 1861002123 | Naw-am Acio Daniels | Physician Assistant | 7467 Volley Dr N, Jacksonville, FL 32277-9368 | 2020-08-03 |
| 1750906640 | Veronica Adriana Dediego | Physician Assistant | 915 W Monroe St Ste 300, Jacksonville, FL 32204-1177 | 2020-06-16 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32225 |
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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.