JACKSONVILLE SPINE CENTER PA (NPI# 1760976260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760976260 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE SPINE CENTER PA |
| Practice Address |
15255 Max Leggett Pkwy Ste 5500 Jacksonville FL 32218-7273 |
| Mailing Address |
10475 Centurion Pkwy N Ste 201 Jacksonville FL 32256-5004 |
| Practice Telephone | 9042233321 |
| Practice Fax Number | 9042232169 |
| Mailing Telephone | 9042233321 |
| Mailing Fax Number | 9042232169 |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2018-06-18 |
| Authorized Official Name | LAURA ELLIOTT (PRACTICE MANAGER) |
| Authorized Official Telephone | 9042233321 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912560798 | Jacksonville Spine Center Pa | Pain Medicine | 2349 Village Square Pkwy Ste 107, Fleming Island, FL 32003-4319 | 2019-04-17 |
| 1194248229 | Jacksonville Spine Center Pa | Pain Medicine | 1100 Plantation Island Dr S Ste 220, St Augustine, FL 32080-5174 | 2017-07-20 |
| 1891309340 | Jacksonville Spine Center Pa | Pain Medicine | 6500 Crill Ave, Palatka, FL 32177-9230 | 2020-09-02 |
| 1326659236 | Jacksonville Spine Center Pa | Pain Medicine | 1699 S 14th St Ste 16, Fernandina Beach, FL 32034-1965 | 2020-08-13 |
| 1881643757 | Jacksonville Spine Center Pa | Pain Medicine | 10475 Centurion Pkwy N Ste 201, Jacksonville, FL 32256-5004 | 2006-05-09 |
| Street Address |
15255 MAX LEGGETT PKWY STE 5500 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32218-7273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003249004 | Thomas Matthew Mattox Jr. | Acupuncturist | 15255 Max Leggett Pkwy Ste 5500, Jacksonville, FL 32218-7273 | 2013-08-13 |
| 1225689599 | Taylor Gregory Trace | Physician Assistant | 15255 Max Leggett Pkwy Ste 5500, Jacksonville, FL 32218-7273 | 2019-09-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684170 | Damon Lamar Baker | Nurse Practitioner | 12533 Sampson Rd, Jacksonville, Fl, FL 32218 | 2020-09-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1932679594 | Alaina Rachelle Stanley | Counselor | 11683 Spring Board Dr, Jacksonville, FL 32218 | 2018-11-27 |
| 1508345133 | War Cry Ministry Inc | Counselor | 435 Eric Ave, Jacksonville, FL 32218 | 2018-08-14 |
| 1285111484 | St Vincent's Full Service Urgent Care, LLC | Clinic/Center | 15510 Max Leggett Parkway, Ste A, Jacksonville, FL 32218 | 2018-07-20 |
| 1427544501 | Derrick Roberts | Behavioral Analyst | 11302 Forestdale Rd, Jacksonville, FL 32218 | 2018-07-02 |
| 1215420229 | Companion & Compassion LLC | Home Health | 856 Poydras Ln W, Jacksonville, FL 32218 | 2018-06-13 |
| 1952894784 | Michael Alexander Aaro | Dentist | 1840 Dunn Ave Ste 3, Jacksonville, FL 32218 | 2018-06-06 |
| 1235629445 | Melissa C Moree | Counselor | 13453 Main St. North, Suite 104, Jacksonville, FL 32218 | 2018-05-14 |
| 1861900896 | Sheila Nowlin | Physical Therapist | 1034 Dunn Ave, Jacksonville, FL 32218 | 2018-01-11 |
| Find all providers in zip 32218 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497006423 | Jacksonville Pain and Injury Center, Inc | Pain Medicine | 4051 Phillips Hwy Ste 2, Jacksonville, FL 32207-6895 | 2012-10-01 |
| 1184945917 | Axiom Pain Management LLC | Pain Medicine | 2160 Dunn Ave, Jacksonville, FL 32218-4718 | 2010-06-16 |
| 1457587891 | Perry Jc Md Pa | Pain Medicine | 7999 Philips Hwy, Ste 302, Jacksonville, FL 32256-4443 | 2009-05-29 |
| 1255351110 | Scott Richard Johnston | Pain Medicine | 250 Huff Dr, Jacksonville, NC 28546-7369 | 2006-07-20 |
| 1194722512 | Craig Allen Kornick | Pain Medicine | 7207 Golden Wings Road, Jacksonville, FL 32244 | 2005-06-30 |
| 1154326973 | Hemant N Shah | Pain Medicine | 9421 Waypoint Pl, Jacksonville, FL 32257-9229 | 2005-06-17 |
| 1487270351 | Formoso Pain Specialists, Pa | Pain Medicine | 11555 Central Pkwy Ste 304, Jacksonville, FL 32224-2694 | 2020-06-17 |
| 1104460096 | Spencer Rice | Pain Medicine | 4063 Salisbury Rd Ste 100, Jacksonville, FL 32216-6199 | 2019-11-04 |
| 1831744549 | Orles Pain Management and Regenerative Medicine Group Pa | Pain Medicine | 4131 University Blvd S Ste 12, Jacksonville, FL 32216-4352 | 2019-08-08 |
| 1356840409 | Advanced Pain Management Group, Inc. | Pain Medicine | 4063 Salisbury Rd Ste 100, Jacksonville, FL 32216-6199 | 2018-02-05 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32218 |
Please comment or provide details below to improve the information on JACKSONVILLE SPINE CENTER PA.
| 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.