MEMORY COAST EMERGENCY PHYSICIANS, LLC (NPI# 1760855597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760855597 |
| Entity Type | Organization |
| Organization Name | MEMORY COAST EMERGENCY PHYSICIANS, LLC |
| Practice Address |
2001 Kingsley Ave Orange Park FL 32073-5148 |
| Mailing Address |
Po Box 80055 Philadelphia PA 19101-0055 |
| Practice Telephone | 4694012386 |
| Mailing Telephone | 4694012386 |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2015-11-18 |
| Authorized Official Name | GREGORY J BYRNE (OFFICER) |
| Authorized Official Telephone | 4694012386 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942666979 | Memory Coast Emergency Physicians, LLC | Physician Assistant | 3625 University Blvd S, Jacksonville, FL 32216-4207 | 2016-01-06 |
| 1124491956 | Memory Coast Emergency Physicians, LLC | Physician Assistant | 3625 University Blvd S, Jacksonville, FL 32216-4207 | 2015-11-02 |
| Street Address |
2001 KINGSLEY AVE |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-5148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417959172 | John Dunlap | Nurse Anesthetist, Certified Registered | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2005-08-12 |
| 1528681657 | Michael Steadman Gerber | Registered Nurse | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-05-22 |
| 1831710961 | Marcus Ramzi Ibrahim | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1497374839 | Ahmed Ebrahim | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-15 |
| 1386263267 | Martin Alla | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5156 | 2020-04-10 |
| 1275152399 | Elizabeth Joyce Bogaty | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-09 |
| 1104445113 | Amanda Brenner | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-09 |
| 1457980641 | Bordin Intachai | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-08 |
| 1942839444 | Michelle Lola | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5156 | 2020-04-06 |
| 1245869890 | Ashraf Abdulhalim | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841517844 | Janel Laura Keener | Emergency Medicine | 2001 Kingsley Ave Dept Of, Orange Park, FL 32073-5156 | 2010-04-29 |
| 1609828110 | Peter A. Rives | Emergency Medicine | 2021 Professional Center Drive, Suite 100, Orange Park, FL 32073-5174 | 2006-05-16 |
| 1295199784 | Matthew Kwan Ho Mui | Emergency Medicine | 2001 Kingsley Ave Dept Of, Orange Park, FL 32073-5148 | 2016-04-11 |
| 1972965390 | Megan Miller | Emergency Medicine | 2001 Kingsley Ave, Orange Park, FL 32073 | 2016-03-24 |
| 1225423429 | Edward Descallar | Emergency Medicine | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2015-04-03 |
| 1679915300 | Kingsley Avenue Emergency Physicians LLC | Emergency Medicine | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2013-07-23 |
| 1902248636 | Florida Em-i Medical Services, Pa | Emergency Medicine | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2013-07-23 |
| 1376985358 | Jordan Farr | Emergency Medicine | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2013-07-19 |
| 1003101288 | Forrest King | Emergency Medicine | 2001 Kingsley Ave, Orange Park, FL 32073-5156 | 2011-06-15 |
| 1780909333 | Steven Warrington | Emergency Medicine | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2010-04-06 |
| Find all providers in ORANGE PARK | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
Please comment or provide details below to improve the information on MEMORY COAST EMERGENCY 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.