SAMUEL PRYN BARKER III (NPI# 1275842916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275842916 |
| Entity Type | Individual |
| Full Name | SAMUEL PRYN BARKER III |
| Credential | D.O. |
| Practice Address |
2806 W Us Highway 90 Suite 102 Lake City FL 32055-4745 |
| Mailing Address |
2806 W Us Highway 90 Ste 102 Lake City FL 32055-4745 |
| Practice Telephone | 3864388391 |
| Practice Fax Number | 3864388629 |
| Mailing Telephone | 3864388391 |
| Mailing Fax Number | 3864388629 |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2012-06-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
OS1259 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | DYNAMIC HEALTH MEDICARE | 81147X | 01 |
| FL | 004598500 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043301682 | Samuel Harrison Barker | Chiropractor | 844 Washington St N Ste 400, Twin Falls, ID 83301-3874 | 2006-09-27 |
| 1972941375 | Samuel Fox Barker | Family Medicine | 800 Scott and White Dr, College Station, TX 77845-6440 | 2013-06-06 |
| Street Address |
2806 W US HIGHWAY 90 SUITE 102 |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32055-4745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891113064 | Mercy Medical Urgent Care Center | Clinic/Center | 2806 W Us Highway 90, Suite 102, Lake City, FL 32055-4745 | 2014-04-03 |
| 1407116544 | Kelly Shannon Paradise | Nurse Practitioner | 2806 W Us Highway 90, Suite 102, Lake City, FL 32055-4745 | 2012-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114439510 | Melissa Fay Peters | Nurse Practitioner | 5085 West Us Highway 90, Lake City, FL 32055 | 2017-10-26 |
| 1851801765 | Stephanie Jo Nogle | Occupational Therapist | Brooks Americare: 4251 Nw American Ln, #103, Lake City, FL 32055 | 2017-10-05 |
| 1831617273 | Erica Mayo | Pharmacist | 4846 Nw Lake Jeffery Rd., Lake City, FL 32055 | 2017-09-06 |
| 1144759333 | Jerry Hamilton Cheesman | Dentist | 217 Ne Franklin Sreet, Lake City, FL 32055 | 2017-06-09 |
| 1487183745 | Joshua Allore | Dentist | 2970 W Us Highway 90., Lake City, FL 32055 | 2017-06-08 |
| 1497298418 | Careing Hands | Preferred Provider Organization | 1471nw Queen Rd, Lakecity, FL 32055 | 2016-11-22 |
| 1881148278 | Corniqueca Stewart-simmons | Nurse Practitioner | 340 Nw Commerce Drive, Lake City, FL 32055 | 2016-08-15 |
| 1164809141 | Latasha Harten-jones | Licensed Practical Nurse | 443 Ne Sims Dr, Lake City, FL 32055 | 2015-04-29 |
| 1154716447 | Lindsey Morton | Counselor | 219 Se Baya Avenue, Lake City, FL 32055 | 2015-04-02 |
| 1124439351 | Tynette Jordan | Counselor | 708 N.w Wilson St., Lake City, FL 32055 | 2014-05-09 |
| Find all providers in zip 32055 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699138917 | Denise Driscoll | Family Medicine | 340 Nw Commerce Dr, Lake City, FL 32055-4709 | 2016-04-04 |
| 1174719629 | Raimah Primary Care Center Pa | Family Medicine | 1283 Sw State Road 47, 103, Lake City, FL 32025-0489 | 2007-09-19 |
| 1053486456 | Dawn Wilson | Family Medicine | 5499 Jonesboro Rd, Lake City, GA 30260-3553 | 2006-11-21 |
| 1588755029 | Ut Van Tran | Family Medicine | 619 S Marion Ave, Lake City, FL 32025 | 2006-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811598105 | Foundations Medical Center Pllc | Family Medicine | 4467 Commons Dr W Ste F-g, Destin, FL 32541-8454 | 2020-11-04 |
| 1831704345 | Vasundhara Kuchibhotla | Family Medicine | 1630 Sw 75th Ter, Gainesville, FL 32607-6604 | 2020-09-11 |
| 1356952170 | Discreet Health Solutions, LLC | Family Medicine | 7124 Pelican Island Dr, Tampa, FL 33634-7463 | 2020-08-14 |
| 1033728019 | Nana Aisha Garba | Family Medicine | 11200 Sw 8th St Ahc2 Rm 589b, Miami, FL 33199-0001 | 2020-07-27 |
| 1043838451 | Lisa M Parker | Family Medicine | 7955 Bay St Ste 2, Sebastian, FL 32958-3282 | 2020-07-13 |
| 1699390336 | Rosenie B Jasmin | Family Medicine | Dove Medical Centers, LLC, 2901 West Oakland Park Blvd Ste A4-5, Oakland Park, FL 33311 | 2020-06-09 |
| 1588287239 | Sarai L Gonzalez | Family Medicine | 16182 Nw 21st St, Pembroke Pines, FL 33028-1255 | 2020-05-28 |
| 1184247033 | Wellness Solutions 2020 LLC | Family Medicine | 2300 N Commerce Pkwy Ste 321, Weston, FL 33326-3257 | 2020-05-27 |
| 1780207910 | Homeville Medical Care | Family Medicine | 11040 Nw 18th Ct, Plantation, FL 33322-3407 | 2020-05-21 |
| 1942829536 | Health Medical Ultra Limited Liability Company | Family Medicine | 1760 Havendale Blvd Nw, Winter Haven, FL 33881-1224 | 2020-04-13 |
| 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.