STANTON L LONGENECKER (NPI# 1821092271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821092271 |
| Entity Type | Individual |
| Full Name | STANTON L LONGENECKER |
| Credential | MD |
| Practice Address |
2 Shircliff Way Ste 300 Credentialing Department Jacksonville FL 32204-4753 |
| Mailing Address |
11945 San Jose Blvd Ste 300 Jacksonville FL 32223-1627 |
| Practice Telephone | 9042045000 |
| Practice Fax Number | 9042044000 |
| Mailing Telephone | 9043961725 |
| Mailing Fax Number | 9043964893 |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2019-08-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | ME49077 | FL | Allopathic & Osteopathic Physicians |
| N | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
ME49077 | FL | Allopathic & Osteopathic Physicians |
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
ME49077 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 062862000 | 05 |
| Street Address |
2 SHIRCLIFF WAY STE 300 CREDENTIALING DEPARTMENT |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-4753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881698652 | Sunday U Ero | Orthopaedic Surgery | 2 Shircliff Way Ste 300, Credentialing Department, Jacksonville, FL 32204-4753 | 2005-06-09 |
| 1265811152 | Ashik Shrestha | Psychiatry & Neurology | 2 Shircliff Way Ste 300, Jacksonville, FL 32204-4753 | 2015-05-25 |
| 1629072079 | H. Lynn Norman | Orthopaedic Surgery | 2 Shircliff Way Ste 300, Credentialing Department, Jacksonville, FL 32204-4753 | 2005-06-13 |
| 1235133984 | Wilbert B Pino Jr. | Specialist | 2 Shircliff Way Ste 300, Jacksonville, FL 32204-4753 | 2005-06-10 |
| 1699779462 | Richard R. Grimsley | Orthopaedic Surgery | 2 Shircliff Way Ste 300, Jacksonville, FL 32204-4753 | 2005-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578043998 | Bahri Orthopedics Institute | Orthopaedic Surgery | 6100 Kennerly Rd Ste 202, Jacksonville, FL 32216-4379 | 2018-08-15 |
| 1215029640 | Robert S Franco | Orthopaedic Surgery | 2054 Riverside Ave, Apt. #5207, Jacksonville, FL 32204-4428 | 2006-09-30 |
| 1326647504 | Ortho One Jacksonville | Orthopaedic Surgery | 6100 Kennerly Rd Ste 202, Jacksonville, FL 32216-4379 | 2020-10-20 |
| 1811472152 | Ortho One | Orthopaedic Surgery | 6100 Kennerly Rd Ste 202, Jacksonville, FL 32216-4379 | 2018-10-02 |
| 1376896522 | Physicians Group Services Pa | Orthopaedic Surgery | 3627 University Blvd S, Suite 435, Jacksonville, FL 32216-4230 | 2012-10-24 |
| 1629378005 | Young Orthopaedics & Sports Medicine, Pa | Orthopaedic Surgery | 9191 R.g. Skinner Parkway, Suite 703, Jacksonville, FL 32256-9662 | 2010-11-01 |
| 1467621003 | Florida Sports Medicine Institute Inc | Orthopaedic Surgery | 4131 University Blvd S, Suite 15, Jacksonville, FL 32216-4326 | 2008-02-28 |
| 1619013851 | Jacksonville Orthopaedic Institute Inc | Orthopaedic Surgery | 1325 San Marco Blvd, Suite 200, Jacksonville, FL 32207-8568 | 2007-01-29 |
| 1306875422 | Georges Abdo El Bahri | Orthopaedic Surgery | 6100 Kennerly Rd, Suite 101, Jacksonville, FL 32216-4368 | 2006-07-01 |
| 1629025820 | Southeast Orthopedic Specialists, Inc. | Orthopaedic Surgery | 2627 Riverside Ave, 3rd Floor, Jacksonville, FL 32204-4712 | 2006-05-31 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
Please comment or provide details below to improve the information on STANTON L LONGENECKER.
| 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.