DR. EDWARD BRIAN JORGENSEN (NPI# 1356325963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356325963 |
| Entity Type | Individual |
| Full Name | DR. EDWARD BRIAN JORGENSEN |
| Credential | D.O. |
| Practice Address |
14114 Alabama St Jay Hospital Jay FL 32565 |
| Practice Telephone | 8506758035 |
| Mailing Telephone | 8506758035 |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2016-05-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 204D00000X | Neuromusculoskeletal Medicine & OMM | OS6227 | FL | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | OS6227 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
14114 ALABAMA ST JAY HOSPITAL |
| City | JAY |
| State | FL |
| Zip Code | 32565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528619004 | Tyler Dewayne Roley | Physical Medicine & Rehabilitation | 14114 Alabama St, Jay, FL 32565-1219 | 2019-09-25 |
| 1013571397 | Taylor Elizabeth Miller | Physical Medicine & Rehabilitation | 14114 Alabama St, Jay, FL 32565-1219 | 2019-04-23 |
| 1255857470 | Lisa Newton | Physical Therapy Assistant | 14114 Alabama St, Jay, FL 32565-1219 | 2017-08-18 |
| 1700302916 | Mark Junior Morrow | Physical Therapy Assistant | 14114 Alabama St, Jay, FL 32565-1219 | 2017-08-18 |
| 1750807954 | Stephanie Jean Samons | Physical Therapy Assistant | 14114 Alabama St, Jay, FL 32565-1219 | 2017-08-18 |
| 1497271613 | Janet Elaine Pospiech | Physical Therapy Assistant | 14114 Alabama St, Jay, FL 32565-1219 | 2017-08-18 |
| 1114443520 | Alex Jones | Physical Therapist | 14114 Alabama St, Jay, FL 32565 | 2017-08-17 |
| 1063938579 | Rhonda L Heflin | Occupational Therapist | 14114 Alabama St, Jay, FL 32565-1219 | 2017-08-16 |
| 1083130546 | Thomas Michael Ashworth | Physical Therapy Assistant | 14114 Alabama St, Jay, FL 32565-1219 | 2017-08-16 |
| 1750560686 | Deborah Ann Jackson | Dietitian, Registered | 14114 Alabama St, Jay, FL 32565-1219 | 2007-10-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336418946 | The Terrace At Ivey Acres of Jay | Assisted Living Facility | 3964 Florida Ave, Jay, FL 32565 | 2011-12-28 |
| 1982908497 | Dura-med Southeast Inc. | Durable Medical Equipment & Medical Supplies | 3877 Hwy 4, Jay, FL 32565 | 2010-12-28 |
| 1750416202 | Jay Pharmacy of Jay,fla Inc | Pharmacy | 14088 Ala St, Jay, FL 32565 | 2007-02-23 |
| 1588605059 | Gregory D Heaton | Optometrist | 14088 Alabama St, Jay, FL 32565 | 2006-06-08 |
| 1871546515 | Cleatious David Smith | Family Medicine | 14088 Alabama St, Jay, FL 32565 | 2006-05-17 |
| 1497710313 | John-stewart Michael Smith | Family Medicine | 14088 Alabama St, Jay, FL 32565-1036 | 2006-04-20 |
| 1407818313 | Marian Barraud Stewart | Pediatrics | 14088 Alabama Street, Jay, FL 32565-1036 | 2006-04-05 |
| 1700403854 | Equity Rx, Pllc | Pharmacy | 14088 Alabama St, Jay, FL 32565-1036 | 2020-07-05 |
| 1497014161 | J S Michael Smith Md Pa | Family Medicine | 14088 Alabama St, Jay, FL 32565-1036 | 2012-05-15 |
| 1710246483 | Jay Pediatrics Pa | Pediatrics | 14088 Alabama St, Jay, FL 32565-1036 | 2012-05-15 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265561385 | Mease Medical Corporation | Family Medicine | 659 S 14th Street, Jay, OK 74346 | 2007-03-05 |
| 1366589608 | Richard H Tidwell Md Pllc | Family Medicine | 2485 N Main Street, Jay, OK 74346-0987 | 2007-01-30 |
| 1346208725 | Richard H Tidwell | Family Medicine | 2485 N Main St, Jay, OK 74346-0987 | 2006-05-03 |
| 1497710313 | John-stewart Michael Smith | Family Medicine | 14088 Alabama St, Jay, FL 32565-1036 | 2006-04-20 |
| 1952377442 | Darrell Robert Mease | Family Medicine | 659 S. 14th St., Bldg. B, Jay, OK 74346 | 2006-02-24 |
| 1770565863 | Delores Maye Burroughs-biron | Family Medicine | 590 Gendron Rd, Jay, VT 05859-9732 | 2005-11-15 |
| 1245223858 | George Thomas Conrad | Family Medicine | 1015 W Washbourne St, Jay, OK 74346-4205 | 2005-08-30 |
| 1477559409 | Mark James Elder | Family Medicine | 3887 Scotts Plaza Dr, Jay, FL 32565-4001 | 2005-06-23 |
| 1144651209 | Mark J Elder Do Pa | Family Medicine | 3887 Scotts Plaza Dr, Jay, FL 32565-4001 | 2013-11-27 |
| 1497014161 | J S Michael Smith Md Pa | Family Medicine | 14088 Alabama St, Jay, FL 32565-1036 | 2012-05-15 |
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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.