JEFFREY D RICKETTS (NPI# 1063495281) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063495281 |
| Entity Type | Individual |
| Full Name | JEFFREY D RICKETTS |
| Credential | PA |
| Practice Address |
836 Prudential Dr Ste 1804 Jacksonville FL 32207 |
| Mailing Address |
1824 King St Ste 200 Jacksonville FL 32204-4736 |
| Practice Telephone | 9043983888 |
| Practice Fax Number | 9044006675 |
| Mailing Telephone | 9043843343 |
| Mailing Fax Number | 9044006671 |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2018-05-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9103298 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 292285100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033172184 | Jeffrey M Ricketts | Anesthesiology | 3333 Evergreen Dr Ne, Grand Rapids, MI 49525-9756 | 2006-04-10 |
| Street Address |
836 PRUDENTIAL DR STE 1804 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063416550 | Joseph David Allen | Physician Assistant | 836 Prudential Dr, Suite 801, Jacksonville, FL 32207-8334 | 2005-06-13 |
| 1245877513 | Monica Pombier | Nurse Practitioner | 836 Prudential Dr, Jacksonville, FL 32207 | 2019-12-05 |
| 1396110581 | Jena Joray Snipes | Nurse Practitioner | 836 Prudential Dr, Ste 1405, Jacksonville, FL 32207-8334 | 2015-12-14 |
| 1801266754 | Melanie Barriger Wilson | Nurse Practitioner | 836 Prudential Dr, Suite 1405, Jacksonville, FL 32207-8334 | 2015-10-05 |
| 1477932002 | Maggie Davis | Nurse Practitioner | 836 Prudential Dr, Suite 1800, Jacksonville, FL 32207-8334 | 2015-05-28 |
| 1114306024 | Baptist Ent Specialists Inc | Otolaryngology | 836 Prudential Dr, Suite 1601, Jacksonville, FL 32207-8334 | 2015-05-26 |
| 1811375918 | Candice Joy Stephenson | Physician Assistant | 836 Prudential Dr, Suite 1601, Jacksonville, FL 32207-8334 | 2015-05-11 |
| 1467882340 | Molly Mckee Turner | Nurse Practitioner | 836 Prudential Dr, Suite 1103, Jacksonville, FL 32207-8334 | 2013-11-14 |
| 1285907311 | Baptist Cardiology, Inc. | Internal Medicine | 836 Prudential Dr, Suite 1700, Jacksonville, FL 32207-8334 | 2012-02-21 |
| 1689962375 | Angela Marie Kaeding | Nurse Practitioner | 836 Prudential Dr, 1800, Jacksonville, FL 32207-8334 | 2011-07-14 |
| 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 | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255858650 | John Matthew Dumas | Physician Assistant | 3640 Newcomb Rd, Jacksonville, FL 32218-1510 | 2017-08-25 |
| 1932432093 | Andrew Gibson | Physician Assistant | 12869 Dunes Ct, Jacksonville, FL 32225-3889 | 2009-09-08 |
| 1871556340 | Kevin Michael Cofran | Physician Assistant | 1838 Mcintosh Pl, Jacksonville, FL 32210-2224 | 2006-04-07 |
| 1811950272 | Jaclyn Michelle Tyo | Physician Assistant | 2627 Riverside Ave Ste 300, Jacksonville, FL 32204-4712 | 2006-04-07 |
| 1912969015 | Wendy Elizabeth Ashby | Physician Assistant | 3639 Darnall Pl, Jacksonville, FL 32217-4215 | 2006-04-04 |
| 1407839616 | Jennifer Renee Wren | Physician Assistant | 1820 Barrs St, Suite 701, Jacksonville, FL 32204-4742 | 2005-11-22 |
| 1962403949 | Katherine Elizabeth Stenberg Curry | Physician Assistant | 841 Prudential Dr, Ufjax - Pediatric Cardiothoracic Surgery, Jacksonville, FL 32207-8329 | 2005-08-02 |
| 1346848173 | Marisa Elaine Long | Physician Assistant | 836 Prudential Dr Ste 1001, Jacksonville, FL 32207-8337 | 2020-10-14 |
| 1235775438 | Jacqueline M Evans | Physician Assistant | 2 Shircliff Way Ste 605, Jacksonville, FL 32204-4762 | 2019-11-22 |
| 1992363733 | Lindsey Allison Baroch | Physician Assistant | 3627 University Blvd S Ste 550, Jacksonville, FL 32216-7401 | 2019-06-05 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
Please comment or provide details below to improve the information on JEFFREY D RICKETTS.
| 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.