STAR SPORTS MEDICINE PA (NPI# 1922117845) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922117845 |
| Entity Type | Organization |
| Organization Name | STAR SPORTS MEDICINE PA |
| Practice Address |
9400 University Pkwy Suite 309 Pensacola FL 32514-5752 |
| Mailing Address |
Po Box 30010 Pensacola FL 32503-1010 |
| Practice Telephone | 8504793320 |
| Practice Fax Number | 8504798789 |
| Mailing Telephone | 8504793320 |
| Mailing Fax Number | 8504798789 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2011-12-20 |
| Authorized Official Name | DR. JULIET MARIE DECAMPOS (PHYSICIAN) |
| Authorized Official Telephone | 8504793320 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE RAILROAD | DG3210 | 01 | |
| FL | 253484300 | 05 |
| Street Address |
9400 UNIVERSITY PKWY SUITE 309 |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32514-5752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720083876 | Bascom Clarence Raney | Family Medicine | 9400 University Pkwy, Suite 409, Pensacola, FL 32514-5752 | 2005-06-16 |
| 1780235390 | Kristina Ducharme | Physical Therapy Assistant | 9400 University Pkwy, Pensacola, FL 32514-5752 | 2019-09-25 |
| 1275196719 | Rahul Dasari | Occupational Therapist | 9400 University Pkwy, Pensacola, FL 32514-5752 | 2019-04-19 |
| 1174036040 | Melissa A Christison | Nurse Practitioner | 9400 University Pkwy, Pensacola, FL 32514-5752 | 2017-11-14 |
| 1356867956 | James Brad Hall | Physical Therapist | 9400 University Pkwy, Pensacola, FL 32514-5752 | 2017-08-16 |
| 1740702026 | William Coggin | Physical Therapist | 9400 University Pkwy, Pensacola, FL 32514-5752 | 2017-07-08 |
| 1225578107 | John Neill | Physician Assistant | 9400 University Pkwy, Suite 309, Pensacola, FL 32514-5752 | 2017-02-27 |
| 1811430127 | Anna Jean Mcgee | Pharmacist | 9400 University Pkwy, Suite 118, Pensacola, FL 32514-5752 | 2016-11-18 |
| 1114477346 | Ashley Nicole Collins | Physician Assistant | 9400 University Pkwy, Pensacola, FL 32514 | 2016-10-12 |
| 1083070502 | Lindsay Phebus | Psychologist | 9400 University Pkwy, Suite 200, Pensacola, FL 32514-5752 | 2016-01-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568920643 | Cameron Rae Mackey | Student in an Organized Health Care Education/Training Program | 9091 Aiway Dr, Apt 622, Pensacola, FL 32514 | 2019-03-07 |
| 1083182612 | B & B of Pensacola LLC | Home Health | 2024 E Olive Rd, Pensacola, FL 32514 | 2018-11-13 |
| 1902398423 | Chana Levy | Developmental Therapist | 10080 Hillview Dr # 387b, Pensacola, FL 32514 | 2018-05-31 |
| 1629407663 | James Daniel Langston | Registered Nurse | 8383 North Davie Highway, Pensacola, FL 32514 | 2013-11-08 |
| 1174956197 | Valerie Kuloba | Pharmacist | 9251 University Parkway, Pensacola, FL 32514 | 2013-08-13 |
| 1548550924 | Pamela Lynn Trammel | Nurse Practitioner | 8383 North Davis Hywy, West Florida Hospital, Pensacola, FL 32514 | 2011-04-19 |
| 1659609378 | Michael Smith | Physical Therapy Assistant | 10100 Hillveiw Dr., Pensacola, FL 32514 | 2009-11-19 |
| 1154582906 | Karen Buchanan Bailey | Dentist | 2322 Copter Road, Pensacola, FL 32514 | 2008-06-24 |
| 1811181985 | Sandra Paquingan Kloman | Registered Nurse | 9400 University Parkway #10c, Medical Professional Agency, Pensacola, FL 32514 | 2007-08-31 |
| 1083826523 | Renfroe Spinal Center LLC | Chiropractor | 1421 East Nine Mile Rd, Pensacola, FL 32514 | 2007-05-04 |
| Find all providers in zip 32514 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528338522 | Paul E Pearson | Specialist | 6400 N Davis Hwy, Suite 2, Pensacola, FL 32504-6903 | 2012-01-06 |
| 1932403409 | Staci Ann Jagoe | Specialist | 455 Shiloh Dr, Pensacola, FL 32503-7713 | 2010-12-27 |
| 1154640308 | Cristen Miller | Specialist | 4470 Spanish Trl, 97, Pensacola, FL 32504-4903 | 2010-05-27 |
| 1437482023 | Daniel Paul Hobgood Iv | Specialist | 4317 Spanish Trl, Pensacola, FL 32504-4942 | 2009-09-14 |
| 1336384783 | Sean Mathew Weiser | Specialist | 744 E Burgess Rd, Suite A105, Pensacola, FL 32504-6227 | 2008-12-12 |
| 1841470895 | Still Waters Medical Spa | Specialist | 20 N Tarragona St, Pensacola, FL 32502-6063 | 2007-11-07 |
| 1306032420 | Janice Leigh Nicholson | Specialist | 4438 Omaha Dr, Pensacola, FL 32507-7746 | 2007-09-21 |
| 1396938247 | Harry James Beecham IIi | Specialist | 5153 N 9th Ave Ste 305, Pensacola, FL 32504-5719 | 2007-08-23 |
| 1174713531 | Kotlarz Ent and Facial Plastic Surgery | Specialist | 6100 N Davis Hwy, Pensacola, FL 32504-6950 | 2007-07-31 |
| 1205036886 | East-west Medical & Rehabilitation Associates Pa | Specialist | 236 W. Garden St, Ste 1, Pensacola, FL 32501 | 2007-07-20 |
| Find all providers in PENSACOLA | ||||
Please comment or provide details below to improve the information on STAR SPORTS MEDICINE 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.