LOGGERHEAD MEDICAL LLC (NPI# 1023041001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023041001 |
| Entity Type | Organization |
| Organization Name | LOGGERHEAD MEDICAL LLC |
| Other Organization Name | ADVANCED PAIN AND NEUROMUSCULAR CONSULTANTS OF BREVARD |
| Practice Address |
307 E New Haven Ave Melbourne FL 32901-4576 |
| Mailing Address |
Po Box 3123 St Augustine FL 32085-3123 |
| Practice Telephone | 3217298223 |
| Practice Fax Number | 3217296252 |
| Mailing Telephone | 9048244990 |
| Mailing Fax Number | 9048242226 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2011-09-15 |
| Authorized Official Name | NANCY L LAYTON (OWNER) |
| Authorized Official Telephone | 3217298223 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
ME105112 | FL | Allopathic & Osteopathic Physicians |
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
ME51048 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 275274301 | 05 | |
| FL | 275274302 | 05 | |
| FL | BCBS | 39339 | 01 |
| FL | MEDICARE RAILROAD | DC0738 | 01 |
| Other Name | Type Code |
|---|---|
| Advanced Pain and Neuromuscular Consultants of Brevard | Doing Business As Name - Organization |
| Street Address |
307 E NEW HAVEN AVE |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-4576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760474712 | Roger P. Thomas | Physical Medicine & Rehabilitation | 307 E New Haven Ave, Melbourne, FL 32901-4576 | 2005-08-16 |
| 1417322488 | Viviane Maria Matarazzo Matchett | Nurse Practitioner | 307 E New Haven Ave, Melbourne, FL 32901-4576 | 2015-12-02 |
| 1265832836 | Susan Shepherd | Nurse Practitioner | 307 E New Haven Ave, Suite 1, Melbourne, FL 32901-4576 | 2014-09-02 |
| 1316287923 | Brett Steininger | Physical Therapist | 307 E New Haven Ave, Suite 2, Melbourne, FL 32901-4576 | 2013-02-19 |
| 1518135888 | Sherin Kamal Fetouh | Physical Medicine & Rehabilitation | 307 E New Haven Ave, Melbourne, FL 32901-4576 | 2008-02-20 |
| 1417076183 | Dan Grinmanis | Physical Therapy Assistant | 307 E New Haven Ave, Suite, Melbourne, FL 32901-4576 | 2007-03-27 |
| 1033243936 | Harbor City Physical Therapy, Pa | Physical Therapist | 307 E New Haven Ave, Suite 2, Melbourne, FL 32901-4576 | 2007-03-15 |
| 1700819612 | Nancy Lr Layton | Pain Medicine | 307 E New Haven Ave, Melbourne, FL 32901-4576 | 2006-07-07 |
| 1285607929 | Lawrence Michael Shneyder | Physical Therapist | 307 E New Haven Ave, Suite 2, Melbourne, FL 32901-4576 | 2006-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629049275 | Todd B Jaffe | Anesthesiology | 8095 Spyglass Hill Rd, Suite 101, Melbourne, FL 32940 | 2006-01-31 |
| 1477823904 | Regina Luwanda Morris Solis | Anesthesiology | 2222 S Harbor City Blvd Ste 610, Melbourne, FL 32901-5591 | 2011-12-30 |
| 1174841084 | Lee Jacob Neubert | Anesthesiology | 7000 Spyglass Ct Ste 310, Melbourne, FL 32940-7948 | 2010-05-17 |
| 1467608521 | Robert Michael Nastasi | Anesthesiology | 2900 Veterans Way, Melbourne, FL 32940 | 2008-08-08 |
| 1164410650 | John J Sassano | Anesthesiology | 2222 S Harbor City Blvd, Suite 610, Melbourne, FL 32901-5594 | 2005-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578181087 | John Peter Lafferty Iv | Anesthesiology | 2039 Hillview St Apt 4, Sarasota, FL 34239-2396 | 2020-07-10 |
| 1679197735 | Dynamic Pain & Wellness Pllc | Anesthesiology | 325 John Knox Rd Bldg 200, Tallahassee, FL 32303-4114 | 2020-06-04 |
| 1689294621 | Advanced Pain Management and Wellness Center | Anesthesiology | 241 Porgee Rock Pl, Jupiter, FL 33458-1635 | 2020-04-20 |
| 1548800808 | Ortho Florida, LLC | Anesthesiology | 11135 S Jog Road Ste 5, Boynton Beach, FL 33437 | 2020-01-14 |
| 1346886033 | Spine and Orthopedic Specialists of Tampa, LLC | Anesthesiology | 6919 N Dale Mabry Hwy Ste 325, Tampa, FL 33614-3860 | 2019-11-18 |
| 1700446077 | Gulf Coast Pain Consultants LLC | Anesthesiology | 182 A East Redstone Ave, Crestview, FL 32539-5371 | 2019-06-18 |
| 1265099386 | Gulf Coast Pain Consultants LLC | Anesthesiology | 10437 Sorrento Rd Ste 203, Pensacola, FL 32507-7620 | 2019-05-23 |
| 1023673951 | Apollo Pain Management | Anesthesiology | 720 Cortaro Drive, Sun City Center, FL 33573 | 2019-05-06 |
| 1861056384 | Englewood Pain Management LLC | Anesthesiology | 2061 Englewood Rd Ste 2a, Englewood, FL 34223-1747 | 2019-04-30 |
| 1962066241 | Doctors Best Wellness Centers Inc | Anesthesiology | 2237 N Commerce Pkwy Ste 3, Weston, FL 33326-3250 | 2019-04-23 |
| Find all providers with the same taxonomy | ||||
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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.