MR. CHARLES TRAVIS GREENLEY


Address: 11555 Central Pkwy, Suite 304, Jacksonville, FL 32224-2691
Phone: 9042657755

MR. CHARLES TRAVIS GREENLEY (NPI# 1740418243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1740418243
Entity Type Individual
Full Name MR. CHARLES TRAVIS GREENLEY
Credential PA-C
Practice Address 11555 Central Pkwy
Suite 304
Jacksonville
FL 32224-2691
Mailing Address 7855 Argyle Forest Blvd
Suite 101
Jacksonville
FL 32244-5596
Practice Telephone 9042657755
Practice Fax Number 9042657754
Mailing Telephone 9042826331
Mailing Fax Number 9042824117
Enumeration Date 2009-06-24
Last Update Date 2015-07-13
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 11555 CENTRAL PKWY
SUITE 304
City JACKSONVILLE
State FL
Zip Code 32224-2691

Providers in the same location

NPI Name Taxonomy Address Enumeration
1265426829 Luis U Ramirez Internal Medicine 11555 Central Pkwy, Ste 200, Jacksonville, FL 32224-2691 2005-09-09
1760880165 Lauren Timney Psychologist 11555 Central Pkwy, Suite 704, Jacksonville, FL 32224-2691 2014-12-17
1346565215 Ashley L Horn Nurse Practitioner 11555 Central Pkwy, Suite 201, Jacksonville, FL 32224-2691 2010-04-02
1679897243 Luis U Ramirez Md Pa Internal Medicine 11555 Central Pkwy, Ste 200, Jacksonville, FL 32224-2691 2010-03-25
1316273733 Lisa Permenter Nurse Practitioner 11555 Central Pkwy, Suite 304, Jacksonville, FL 32224-2691 2009-10-20
1679716344 Haitao Zhang Internal Medicine 11555 Central Pkwy, Suite 304, Jacksonville, FL 32224-2691 2009-04-10
1245425065 Dima Nassour Nassour Internal Medicine 11555 Central Pkwy, Suite 204, Jacksonville, FL 32224-2691 2007-09-14
1801000161 Ferdinand Joseph Formoso Physical Medicine & Rehabilitation 11555 Central Pkwy, Suite 304, Jacksonville, FL 32224-2691 2007-05-09
1326050105 Jose P Vindas Cordero Specialist 11555 Central Pkwy, Suite 204, Jacksonville, FL 32224-2691 2006-08-12

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NPI Name Taxonomy Address Enumeration
1356974372 Noelle Parker Specialist/Technologist 1 Unf Drivve, Jacksonville, FL 32224 2020-02-18
1124685102 Charcy Rene Stiller Specialist/Technologist 1 Unf Dr., Jacksonville, FL 32224 2019-05-24
1265097513 Mayo Clinic Jacksonville Ambulance 13970 Zumbro Dr, Jacksonville, FL 32224 2019-05-02
1639681471 Brigantti Anesthesia & Spine Care Clinic/Center 1361 13th Ave South Suite #210, Jacksonville, FL 32224 2017-11-02
1093240061 Beric Emilio Berlioz Anesthesiology 4500 San Pablo Rd S # J, Jacksonville, FL 32224 2017-04-26
1609240746 Matthew James Dailey Nurse Anesthetist, Certified Registered 2500 San Pablo Rd S, Jacksonville, FL 32224 2015-11-29
1003299603 Upscale Personal Care Home Assisted Living Facility 4375 Autumn River Road, Jacksonville, FL 32224 2015-07-01
1629459375 Bellanid Fonseca Social Worker 3694 Summerlin Ln E, Jacksonville, FL 32224 2015-06-17
1164840500 Nicholas Scotto Physical Therapist 11555 Central Pkwy Ste 1104, Jacksonville, FL 32224 2014-04-02
1497093454 Quicker Care Urgent Care Point of Service 13770 Beach Blvd., Unit # 4, Jacksonville, FL 32224 2013-01-27
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
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Competitor

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City JACKSONVILLE
Zip Code 32224

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Dataset Information

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.

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