RIVER WATCH ACUTE TRAUMA LLC (NPI# 1386066728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386066728 |
| Entity Type | Organization |
| Organization Name | RIVER WATCH ACUTE TRAUMA LLC |
| Practice Address |
2001 Kingsley Ave Orange Park FL 32073-5148 |
| Mailing Address |
13737 Noel Rd Ste 1600 Dallas TX 75240-1331 |
| Practice Telephone | 9042768500 |
| Mailing Telephone | 9548382371 |
| Enumeration Date | 2014-01-18 |
| Last Update Date | 2019-09-12 |
| Authorized Official Name | GREGORY BYRNE (PRESIDENT) |
| Authorized Official Telephone | 9548382371 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0127X |
Surgery Specialization: Trauma Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
2001 KINGSLEY AVE |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-5148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417959172 | John Dunlap | Nurse Anesthetist, Certified Registered | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2005-08-12 |
| 1528681657 | Michael Steadman Gerber | Registered Nurse | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-05-22 |
| 1831710961 | Marcus Ramzi Ibrahim | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1497374839 | Ahmed Ebrahim | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-15 |
| 1386263267 | Martin Alla | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5156 | 2020-04-10 |
| 1275152399 | Elizabeth Joyce Bogaty | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-09 |
| 1104445113 | Amanda Brenner | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-09 |
| 1457980641 | Bordin Intachai | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-08 |
| 1942839444 | Michelle Lola | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5156 | 2020-04-06 |
| 1245869890 | Ashraf Abdulhalim | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Orange Park, FL 32073-5148 | 2020-04-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427397264 | Orange Park Acute Trauma,llc | Surgery | 2140 Kingsley Ave, Suite 14, Orange Park, FL 32073-5180 | 2013-02-13 |
| 1487954723 | Travis Randall Von Tobel | Surgery | 1895 Kingsley Ave Ste 903, Orange Park, FL 32073-4410 | 2010-11-02 |
| 1699783357 | Eric J Ferguson | Surgery | 1895 Kingsley Ave, Suite 300, Orange Park, FL 32073-4466 | 2006-08-04 |
| 1558329789 | Michael S. Gilligan | Surgery | 1555 Kingsley Ave, Suite 503, Orange Park, FL 32073-9207 | 2006-05-04 |
| 1245288471 | Debbie A. Berlin | Surgery | 1555 Kingsley Ave, Suite 503, Orange Park, FL 32073-9207 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301263 | Heather Marie Gable | Surgery | 6150 Diamond Centre Ct # 1300, Fort Myers, FL 33912-4367 | 2020-09-21 |
| 1932713476 | Gabriel Nicolas Chapman | Surgery | 12301 Trout Cir, Spring Hill, FL 34609-4962 | 2020-09-02 |
| 1396356960 | After Hours Surgical Care LLC | Surgery | 11766 Foxbriar Lake Trl, Boynton Beach, FL 33473-7830 | 2020-08-16 |
| 1588288203 | Samuel Joseph | Surgery | 22730 Sw 55th Ave, Boca Raton, FL 33433-6258 | 2020-05-29 |
| 1720601768 | Ked Medical, P.a. | Surgery | 3001 N Rocky Point Dr E Ste 100, Tampa, FL 33607-5860 | 2020-05-26 |
| 1952922270 | Glenn Edmund Bryan Jr. | Surgery | 4255 N Us Highway 1, Melbourne, FL 32935-4822 | 2020-04-27 |
| 1821618729 | Herbert Paul Lerner | Surgery | 10815 Royal Devon Way, Lake Worth, FL 33449-8650 | 2020-04-21 |
| 1003441981 | Comprehensive Care Partners | Surgery | 3101 University Blvd S Ste 100, Jacksonville, FL 32216-2750 | 2020-03-11 |
| 1831749977 | Imed Surgical of Miami, Pa | Surgery | 175 Sw 7th St Ste 1710, Miami, FL 33130-2957 | 2019-09-19 |
| 1174170914 | Vip Surgeries | Surgery | 1301 E Broward Blvd Ste 220, Fort Lauderdale, FL 33301-2111 | 2019-08-26 |
| Find all providers with the same taxonomy | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
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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.