NAVAL HOSPITAL JACKSONVILLE (NPI# 1265411383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265411383 |
| Entity Type | Organization |
| Organization Name | NAVAL HOSPITAL JACKSONVILLE |
| Practice Address |
2080 Child St Jacksonville FL 32214-5005 |
| Practice Telephone | 9045427787 |
| Practice Fax Number | 9045427651 |
| Mailing Telephone | 9045427787 |
| Mailing Fax Number | 9045427651 |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2008-06-18 |
| Authorized Official Name | DR. ELAINE WAGNER (EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9045427312 |
| Authorized Official Credential | DENTIST |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | J0352 | TX | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891009262 | Naval Hospital Jacksonville | Military Hospital | 2080 Child St, Jacksonville, FL 32214-5000 | 2010-07-28 |
| 1285731034 | Naval Hospital Jacksonville | Military/U.S. Coast Guard Pharmacy | 814 Radford Blvd, Bldg 7200, Albany, GA 31704-5000 | 2006-09-20 |
| 1881618346 | Naval Hospital Jacksonville | Emergency Medicine | Naval Hospital Jacksonville, Jacksonville, FL 32099 | 2006-07-27 |
| 1124050448 | Naval Hospital Jacksonville | Family Medicine | 2080 Child St, Jacksonville, FL 32214-5005 | 2006-07-07 |
| 1194768879 | Naval Hospital Jacksonville | Family Medicine | 2080 Child St, Jacksonville, FL 32214-5005 | 2006-06-13 |
| 1962468389 | Naval Hospital Jacksonville | Military Hospital | 2080 Child St, Jacksonville, FL 32214-5005 | 2006-04-25 |
| 1326017419 | Naval Hospital Jacksonville | Military Hospital | 2080 Child St, Naval Hospital Jacksonville- Internal Medicine Clinic, Jacksonville, FL 32214-5005 | 2006-03-14 |
| 1780655373 | Naval Hospital Jacksonville | Nurse Practitioner | Naval Hospital Jacksonville, Jacksonville, FL 32214-0001 | 2006-01-31 |
| Street Address |
2080 CHILD ST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32214-5005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205836202 | Juan Pedro Rivera | Psychiatry & Neurology | 2080 Child St, Jacksonville, FL 32214-5005 | 2005-08-01 |
| 1477169662 | Bobby Joe Neal Kimbro | General Practice | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-09-22 |
| 1659986529 | Henry Lee Simmons Jr. | Pharmacist | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-09-09 |
| 1982228441 | Chantel Charais | Nurse Practitioner | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-06-01 |
| 1598388936 | Joseph Royer | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-05-20 |
| 1780206359 | Devin Alan Rickard | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-05-17 |
| 1881216307 | Adam Dillon Ratcliff | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-05-07 |
| 1619598588 | Sarah Chilson | Nurse Practitioner | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-05-02 |
| 1942820360 | Gregory Hay | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-04-27 |
| 1568083996 | Aaron Hancock | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699255653 | Natalia Rosa Terreros | Nurse Practitioner | 2080 Childs Street, Jacksonville, FL 32214 | 2018-08-20 |
| 1841586120 | Travis Christopher Allemang | Urology | 2080 Child St Dept 5000, Jacksonville, FL 32214 | 2011-06-24 |
| 1730169202 | Quinn Steven Bastian | Psychologist | 2080 Child Street, Mental Health Dept - Bldg 2034 / Nh Jax, Jacksonville, FL 32214 | 2006-01-19 |
| 1760753982 | Jennifer Marie Brooks | Registered Nurse | 2080 Child Street, Jacksonville, FL 32214 | 2012-01-19 |
| 1114298338 | Louis Humberto Grass IIi | Registered Nurse | 2080 Child Street, Anesthesia Dept, Jacksonville, FL 32214 | 2012-01-19 |
| 1851685713 | John Manning Lydon | Obstetrics & Gynecology | 2080 Child Street, Jacksonville, FL 32214 | 2011-06-07 |
| 1093865693 | Elisha Yvette Hansack | Pharmacist | 2080 Child Street, Jacksonville, FL 32214 | 2007-01-12 |
| 1073544466 | Ren-chang Liu | Radiology | 2080 Child Street, Jacksonville, FL 32214 | 2006-07-05 |
| 1598795742 | Beverly B. Nysewander | Nurse Practitioner | 2080 Child Street, Internal Medicine, Jacksonville, FL 32214 | 2006-07-04 |
| 1841823606 | Christine Due Higgins | Midwife | Naval Hospital Jacksonville 2089 Child St, Jacksonville, FL 32214-0001 | 2020-02-19 |
| Find all providers in zip 32214 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427690353 | Emergency Physicians Inc | Emergency Medicine | 9868 Family Place, Jacksonville, FL 32222 | 2019-10-11 |
| 1104301159 | Emergency Physicians Inc | Emergency Medicine | 14534 Old St Augustine Rd, Suite 3110, Jacksonville, FL 32258 | 2018-09-26 |
| 1922525229 | Dwic of Tampa Bay, Inc | Emergency Medicine | 11985 Atlantic Boulevard, Jacksonville, FL 32225-2919 | 2017-08-28 |
| 1063945541 | Hassan Mohammad Aboudan | Emergency Medicine | 8455 Stables Rd, Jacksonville, FL 32256-7265 | 2017-04-11 |
| 1639626476 | Emergency Physicians Inc | Emergency Medicine | 11250 Baptist Health Drive, Suite 713, Jacksonville, FL 32218 | 2016-09-09 |
| 1497107957 | Frank Rodriguez | Emergency Medicine | 7615 Hunters Grove Rd, Jacksonville, FL 32256-7210 | 2016-07-08 |
| 1649631391 | Emergency Physicians Inc | Emergency Medicine | 4085 Town Center Pkwy, Jacksonville, FL 32246-8580 | 2016-03-09 |
| 1619387099 | John Michael Kiel | Emergency Medicine | Department of Emergency Medicine, 125 Floor Clinical Ce, 655 West 8th Street, C506, Jacksonville, FL 32209-3220 | 2014-05-06 |
| 1225455306 | James Esser Barr | Emergency Medicine | 653 W 8th St # L15, Jacksonville, FL 32209-6511 | 2014-03-26 |
| 1992122170 | Nadia Bakor | Emergency Medicine | 6477 103rd St, Jacksonville, FL 32210-7129 | 2014-03-25 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32214 |
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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.