MR. JEFFREY MICHAEL GREEN (NPI# 1912979584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912979584 |
| Entity Type | Individual |
| Full Name | MR. JEFFREY MICHAEL GREEN |
| Credential | PA-C |
| Practice Address |
11555 Central Pkwy Ste 304 Jacksonville FL 32224-2694 |
| Mailing Address |
7855 Argyle Forest Blvd Ste 101 Jacksonville FL 32244-5597 |
| Practice Telephone | 9042657755 |
| Practice Fax Number | 9042657754 |
| Mailing Telephone | (904) 282-6331 |
| Mailing Fax Number | 9042824117 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA3530 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 2910942-00 | 05 | |
| GA | 000645455C | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1361 13th Ave S Ste 250, Jacksonville, FL 322503238 | 9042657755 | 9042657754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699395228 | Jeffrey Scott Green | Pharmacist | 3931 State Highway 37, Ogdensburg, NY 13669-4237 | 2020-04-23 |
| 1104264647 | Jeffrey Paul Green | Dentist | 109 Grandview Way, Missoula, MT 59803-3359 | 2013-06-06 |
| 1043587405 | Jeffrey David Green | Nurse Practitioner | 733 Us 1, North Palm Beach, FL 33408-4513 | 2011-11-29 |
| 1801040886 | Jeffrey Green | Registered Nurse | 13800 E Marina Dr Apt 211, Aurora, CO 80014-3785 | 2008-11-04 |
| 1932389814 | Jeffrey Robert Green | Naturopath | 8707 Jackrabbit Ln Ste A, Belgrade, MT 59714-8995 | 2007-11-08 |
| 1649480245 | Jeffrey Green | Dentist | 149 N Midland St, Merrill, MI 48637 | 2007-05-23 |
| 1558499137 | Jeffrey Harris Green | Psychiatry & Neurology | 170 Cold Soil Road, Cedar Glen Professional Association, Princeton, NJ 08540-4202 | 2007-03-02 |
| 1235275462 | Jeffrey J. Green | Physical Therapist | 1 Royal Park Dr, Ste 2, Zeeland, MI 49464-2242 | 2007-01-29 |
| 1407928849 | Jeffrey Scott Green | Chiropractor | 3020 Richfield Rd, Flint, MI 48506-2472 | 2006-11-14 |
| 1104917558 | Jeffrey L Green | Nurse Anesthetist, Certified Registered | 1524 W 5th St, Sheridan, WY 82801-2707 | 2006-09-28 |
| Street Address |
11555 CENTRAL PKWY STE 304 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32224-2694 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487270351 | Formoso Pain Specialists, Pa | Pain Medicine | 11555 Central Pkwy Ste 304, Jacksonville, FL 32224-2694 | 2020-06-17 |
| 1881089613 | Physicians Group Services | Family Medicine | 11555 Central Pkwy Ste 304, Jacksonville, FL 32224-2694 | 2015-03-30 |
| 1396007993 | Andrew David Green | Nurse Practitioner | 11555 Central Pkwy Ste 304, Jacksonville, FL 32224-2694 | 2012-06-11 |
| 1346554771 | Physicians Group Services Pa | Family Medicine | 11555 Central Pkwy Ste 304, Jacksonville, FL 32224-2694 | 2010-07-27 |
| 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 |
| Find all providers in zip 32224 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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. |
| 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 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32224 |
Please comment or provide details below to improve the information on MR. JEFFREY MICHAEL GREEN.
| 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.