JENNIFER GRACE CORCORAN (NPI# 1952824575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952824575 |
| Entity Type | Individual |
| Full Name | JENNIFER GRACE CORCORAN |
| Credential | PA-C |
| Practice Address |
807 Childrens Way Jacksonville FL 32207 |
| Mailing Address |
10140 Centurion Pkwy N Jacksonville FL 32256-0532 |
| Practice Telephone | 9046973600 |
| Practice Fax Number | 9046973927 |
| Mailing Telephone | 9046974127 |
| Mailing Fax Number | 9046975102 |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2018-08-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9110904 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 024816100 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8803 Waterfront Ter, Jacksonville, FL 322174600 | 9042261536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780130880 | Jennifer Corcoran | Specialist/Technologist | 2 Marchand Way, Norton, MA 02766-1844 | 2016-08-29 |
| 1790183713 | Jennifer Corcoran | Social Worker | 6515 George Washington Mem Hwy Ste 100, Yorktown, VA 23692-2182 | 2014-12-08 |
| 1558403436 | Jennifer Mary Corcoran | Physical Therapist | 7575 E Indian Bend Rd, #1101, Scottsdale, AZ 85250-4660 | 2007-02-13 |
| 1528559762 | Jennifer Corcoran | Student in an Organized Health Care Education/Training Program | 601 Elmwood Ave, Rochester, NY 14642-0001 | 2018-05-23 |
| 1881095735 | Jennifer L Corcoran | Physician Assistant | 50 Moisey Dr, Suite 214, Hazle Township, PA 18202-9297 | 2014-09-10 |
| 1760733844 | Jennifer Corcoran | Speech-Language Pathologist | 620 Sleepy Hollow Road, Briarcliff Manor, NY 10510 | 2012-09-28 |
| 1689835159 | Jennifer L Corcoran | Social Worker | 421 Fallsway, Baltimore, MD 21202-4800 | 2008-06-18 |
| 1639290372 | Jennifer J Corcoran | Speech-Language Pathologist | 8710 Emge Rd, Baltimore, MD 21234-3504 | 2007-04-02 |
| 1720119803 | Jennifer Corcoran | Speech-Language Pathologist | 12110 Clayton Rd, Saint Louis, MO 63131-2516 | 2007-03-08 |
| Street Address |
807 CHILDRENS WAY |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740281658 | Elizabeth A Moran | Orthopaedic Surgery | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2005-08-02 |
| 1689229213 | Madyson Marie Hund | Audiologist | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2019-08-09 |
| 1336792829 | Graciela Teresita Gallo | Psychiatry & Neurology | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2019-07-23 |
| 1538712013 | Vanessa V Oliveira Valente | Surgery | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2019-07-23 |
| 1679031181 | Navondria Lawson | Nurse Practitioner | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2019-03-05 |
| 1952870644 | Jessica Alice Johnson | Nurse Practitioner | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2018-11-25 |
| 1831676584 | Lukas Scott Hayden | Physician Assistant | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2018-07-25 |
| 1053807750 | Christine Nichole Crews | Psychiatry & Neurology | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2018-07-05 |
| 1134610470 | Rocio Krystal Rivera-valentin | Student in an Organized Health Care Education/Training Program | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2018-05-22 |
| 1144726696 | Paige Marie Ryan | Student in an Organized Health Care Education/Training Program | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2018-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| 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 | 32207 |
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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.