ADAM RYAN GLASSICK (NPI# 1013211937) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013211937 |
| Entity Type | Individual |
| Full Name | ADAM RYAN GLASSICK |
| Credential | PA-C |
| Practice Address |
12303 San Jose Blvd Jacksonville FL 32223-2640 |
| Mailing Address |
570 Sternwheel Dr St Johns FL 32259-8662 |
| Practice Telephone | 9042880277 |
| Mailing Telephone | 5404604236 |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2020-08-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9105842 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
022420 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 003323800 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12303 San Jose Blvd, Jacksonville, FL 322232640 | 9042880277 | |
| 474 Route 3, Plattsburgh, NY 12901 | 5185363071 | 5185363075 |
| Street Address |
12303 SAN JOSE BLVD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32223-2640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821044140 | Pennye Brosche Arehart | Nurse Practitioner | 12303 San Jose Blvd, Carespot, Jacksonville, FL 32223-2640 | 2006-05-26 |
| 1689996464 | Solantic Urgent Care | Pharmacy | 12303 San Jose Blvd, Jacksonville, FL 32223-2640 | 2010-02-22 |
| 1962640276 | Kurtis Hostetter | Family Medicine | 12303 San Jose Blvd, Jacksonville, FL 32223-2640 | 2009-01-23 |
| 1881609733 | Theresa Marie Hershfield | Nurse Practitioner | 12303 San Jose Blvd, Jacksonville, FL 32223-2640 | 2006-07-29 |
| 1023058682 | Girija Chandran | Family Medicine | 12303 San Jose Blvd, Jacksonville, FL 32223-2640 | 2006-06-08 |
| 1790722684 | Viky Divertie | Nurse Practitioner | 12303 San Jose Blvd, Jacksonville, FL 32223-2640 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679103600 | Karen Gabriela Alexander | Dietitian, Registered | Ackerman Cancer Center, 10881 San Jose Blvd, Jacksonville, FL 32223 | 2020-01-17 |
| 1891250049 | Thalia L Honea | Occupational Therapist | 12766 San Jose Blvd, Suite 716 & 717, Jacksonville, FL 32223 | 2019-02-01 |
| 1447758289 | Stephanie Ann Murphy | Marriage & Family Therapist | 11543 Halethorpe Drive, Jacksonville, FL 32223 | 2018-01-26 |
| 1861948481 | Nicole Gay | Developmental Therapist | 12276 San Jose Blvd, Ste 5, Jacksonville, FL 32223 | 2016-09-01 |
| 1740694439 | Robyn K Mizelle | Behavioral Analyst | 12276 San Jose Blvd. Great Strides Rehabilitation, Suite 507, Jacksonville, FL 32223 | 2014-06-20 |
| 1184038010 | Kelli Anne Cabrera | Occupational Therapist | 12350 San Jose Blvd, Jacksonville, FL 32223 | 2014-06-18 |
| 1891031910 | Mandarin Family Medicine, P.a. | Preferred Provider Organization | 12276-210 San Jose Blvd, Jacksonville, FL 32223 | 2012-12-18 |
| 1114201811 | Darshana Choksi | Pharmacist | 3663 Marbon Rd, Jacksonville, FL 32223 | 2011-09-30 |
| 1346539988 | Harris Wilcox and Donovan Pa | Optometrist | 11790 San Jose Bl, Jacksonville, FL 32223 | 2011-04-05 |
| 1740517796 | Beth A. Kelley | Occupational Therapist | 2640 Scott Mill Dr, Jacksonville, FL 32223 | 2009-11-12 |
| Find all providers in zip 32223 | ||||
| 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 | 32223 |
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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.