DR. DAVID MICHAEL TATERA (NPI# 1326557976) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326557976 |
| Entity Type | Individual |
| Full Name | DR. DAVID MICHAEL TATERA |
| Credential | PH.D. |
| Practice Address |
554 Keily Street Jacksonville FL 32212 |
| Practice Telephone | (757) 953-7550 |
| Practice Fax Number | 7579537560 |
| Mailing Telephone | 7579537550 |
| Mailing Fax Number | 7579537560 |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2017-09-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
0002287 | CO | Behavioral Health & Social Service Providers |
| Street Address |
554 KEILY STREET |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326019373 | Brian G Norwood | Pediatrics | 554 Keily Street, Jacksonville, FL 32212 | 2006-01-29 |
| 1811461726 | Yocelin Hernandez Rojero | Occupational Therapist | 554 Keily Street, Jacksonville Fl 32212, Jacksonville, FL 32212 | 2019-01-14 |
| 1609381235 | Miranda Shilelagh Schmidt | Physician Assistant | 554 Keily Street, Jacksonville, FL 32212 | 2017-12-05 |
| 1144733627 | Tylisha Elyse Deshields | Social Worker | 554 Keily Street, Jacksonville, FL 32212 | 2017-11-07 |
| 1104335348 | Kuang-hui Lee | General Practice | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-20 |
| 1548788177 | Sophia Renee Beal | Speech-Language Pathologist | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-04 |
| 1164949418 | George S Bennitt | Dentist | 554 Keily Street, Jacksonville, FL 32212-4047 | 2017-08-28 |
| 1124545389 | David Phillips | Student in an Organized Health Care Education/Training Program | 554 Keily Street, Centralized Credential and Privileging Directorate, Jacksonville, FL 32212-2466 | 2017-08-28 |
| 1902323652 | Erich Chen | Student in an Organized Health Care Education/Training Program | 554 Keily Street, Jacksonville, FL 32212 | 2017-08-24 |
| 1871010751 | David Facer | Dentist | 554 Keily Street, Jacksonville, FL 23227 | 2017-08-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1518484427 | Amy Kathryn Lee | Student in an Organized Health Care Education/Training Program | Bumed, Centralized Credential & Privileging Directorate, 554 Keily Street, Jacksonville, FL 32212 | 2017-08-23 |
| 1659827970 | Noah Fixelle | Dentist | Bureau of Med and Surg Ccpd, 554 Keily Street, Jacksonville, VA 32212 | 2016-08-28 |
| 1972953339 | Colin Kenneth Kelly | General Practice | Bureau of Medicine & Surgery Detachment, Nas Jacksonville, Building 554, Jacksonville, FL 32212 | 2016-06-16 |
| 1912382359 | Caitlyn Brooke Hoysock | Dentist | 554 Keiley Street, Bureau of Medicine and Surgery - Credentials, Jacksonville, FL 32212 | 2015-07-28 |
| 1285017418 | John Alexander Ruch | Dentist | 554 Keily Street Bureau of Med and Surg Ccpd, Jacksonville, FL 32212 | 2015-07-07 |
| 1407238561 | Amanda Mona Lau | Student in an Organized Health Care Education/Training Program | 554 Kelly Street, Attn Centralized Credentialing, Bureau of Medicine and Surgery, Jacksonville, FL 32212 | 2015-06-25 |
| 1063894715 | Heather Dehaan | Family Medicine | 554 Kelly Street Bureau of Medicine and Surgery, Attention: Centralized Credentialing & Privileging Dire, Jacksonville, FL 32212 | 2015-06-18 |
| 1912389677 | Catherine Garcia | Student in an Organized Health Care Education/Training Program | 554 Kelly St, Credentialing & Privileging Directorate, Bureau of Medicine & Surgery, Attention: Centralized, Jacksonville, FL 32212 | 2015-06-18 |
| 1255712675 | James Robert Benson | Dentist | 734 Keily Street, Bumed, Jacksonville, FL 32212 | 2015-06-11 |
| Find all providers in zip 32212 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336740224 | North Florida Collaborative Therapy | Psychologist | 9652 Morgan Creek Ct, Jacksonville, FL 32222-5808 | 2020-11-05 |
| 1306456058 | Southern Oregon Cbt LLC | Psychologist | 690 G St Ste C, Jacksonville, OR 97530-3208 | 2020-08-07 |
| 1013408004 | Marisa Victoria Byles | Psychologist | 12443 San Jose Blvd Ste 202, Jacksonville, FL 32223-8648 | 2018-05-24 |
| 1306203245 | Robin Jones | Psychologist | 200 Valencia Dr Ste 194, Jacksonville, NC 28546-6311 | 2016-01-22 |
| 1336510452 | Nour Mahmoud Abdelghani | Psychologist | 524 Skymarks Dr Unit 5, Jacksonville, FL 32218-7254 | 2015-10-15 |
| 1295105823 | Mhealthcare Co. | Psychologist | 3805 Valencia Rd, Jacksonville, FL 32205-9271 | 2015-09-24 |
| 1629406400 | Max Aaron Horovitz | Psychologist | 10475 Centurion Pkwy N Ste 301, Jacksonville, FL 32256-5004 | 2013-10-14 |
| 1457786915 | Coral Gaffney | Psychologist | 6488 103rd St., Ste B, Jacksonville, FL 32210 | 2013-09-03 |
| 1801236542 | Jeffrey Allan Rommel | Psychologist | 11150 Castlemain Cir S, Jacksonville, FL 32256-4825 | 2013-06-26 |
| 1326483017 | Amy Melinda Hartley | Psychologist | 8355 Merchants Gate Dr, Jacksonville, FL 32222-5848 | 2013-05-08 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32212 |
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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.