JUDY STOVALL RIVENBARK (NPI# 1851672372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851672372 |
| Entity Type | Individual |
| Full Name | JUDY STOVALL RIVENBARK |
| Credential | M.D. |
| Practice Address |
555 Stockton Street Jacksonville FL 32204 |
| Mailing Address |
Post Office Box 15580 Fernandida Beach FL 32035 |
| Practice Telephone | 8008888776 |
| Mailing Telephone | 8008888776 |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2011-08-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
ME81633 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
555 STOCKTON STREET |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306328745 | Elaine Jones | Registered Nurse | 555 Stockton Street, Jacksonville, FL 32204 | 2018-09-01 |
| 1770065112 | Gabriel Butts | Registered Nurse | 555 Stockton Street, Jacksonville, FL 32204 | 2018-09-01 |
| 1689156028 | Barbara Cozier | Registered Nurse | 555 Stockton Street, Jacksonville, FL 32204 | 2018-09-01 |
| 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 | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558521823 | University of Florida Jacksonville Physicians Inc | Psychiatry & Neurology | 655 W 8th St, Ufjp Psychiatry, Jacksonville, FL 32209-6511 | 2008-06-11 |
| 1457403800 | Eduardo Augusto Sanchez | Psychiatry & Neurology | 1667 Atlantic Blvd, Jacksonville, FL 32207-3346 | 2007-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313472 | Athena Medical LLC | Psychiatry & Neurology | 2001 Hollywood Blvd Ste 207, Hollywood, FL 33020-4536 | 2020-07-21 |
| 1720612013 | New Perspective Mental Health LLC | Psychiatry & Neurology | 6141 Sw 72nd St Ste 402, South Miami, FL 33143-5026 | 2020-02-26 |
| 1972165231 | Blossoming Wellbeing Corp. | Psychiatry & Neurology | 6622 32nd Way S, St Petersburg, FL 33712-5408 | 2019-07-07 |
| 1104391648 | Summit Detox | Psychiatry & Neurology | 3330 S. Federal Highway, 3rd Floor, Boynton Beach, FL 33435 | 2018-10-11 |
| 1679057814 | United Health and Wellness Group, Inc. | Psychiatry & Neurology | 201 N Federal Hwy Ste 105, Deerfield Beach, FL 33441-3621 | 2018-09-24 |
| 1467934224 | Arh Medical Group LLC | Psychiatry & Neurology | 631 Us Highway 1 Ste 409, North Palm Beach, FL 33408-4621 | 2018-08-29 |
| 1255879060 | Round Care, Inc | Psychiatry & Neurology | 300 W Sunrise Blvd Ste 3, Ft Lauderdale, FL 33311-6200 | 2017-02-01 |
| 1154766541 | Paul Roberts | Psychiatry & Neurology | 8529 Southpark Cir, Suite 270, Orlando, FL 32819-9029 | 2013-04-30 |
| 1386910172 | Siddharth Singh Arora | Psychiatry & Neurology | 1811 S Orlando Ave Ste A, Cocoa Beach, FL 32931-2340 | 2012-03-27 |
| 1194010694 | Laurie Ann Solomon | Psychiatry & Neurology | 100 Newell Dr # L4100, Gainesville, FL 32611-1912 | 2011-06-13 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
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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.