DR. FRED JOE POWELL (NPI# 1609078542) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609078542 |
| Entity Type | Individual |
| Full Name | DR. FRED JOE POWELL |
| Credential | M.D. |
| Practice Address |
111 Nature Walk Parkway Suite 108 St. Augustine FL 32092 |
| Practice Telephone | 9042307180 |
| Practice Fax Number | 9042307181 |
| Mailing Telephone | 9042307180 |
| Mailing Fax Number | 9042307181 |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2010-07-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
ME 80996 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730637794 | Fred M Powell | Nurse Practitioner | 100 Wilson Rd, Bentleyville, PA 15314-1028 | 2016-09-19 |
| 1225129190 | Fred A Powell | Registered Nurse | 6128 E 38th St, Suite# 305, Tulsa, OK 74135-5832 | 2006-09-27 |
| Street Address |
111 NATURE WALK PARKWAY SUITE 108 |
| City | ST. AUGUSTINE |
| State | FL |
| Zip Code | 32092 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124670146 | Kaitlyn Thomas | Speech-Language Pathologist | 111 Nature Walk Pkwy # B101, Saint Augustine, FL 32092 | 2019-07-10 |
| 1386168359 | Westminster Pines, Inc. | Skilled Nursing Facility | 235 Towerview Drive, St. Augustine, FL 32092 | 2017-08-01 |
| 1255852471 | St Vincent's Urgent Care Inc | Clinic/Center | 2001 Country Road 210 West, St Augustine, FL 32092 | 2017-06-28 |
| 1649702291 | Leonard Volpe | Physician Assistant | 745 Porta Rosa Cir, St Augustine, FL 32092 | 2017-04-03 |
| 1740630425 | Sierra Danielle Shultz | Behavioral Analyst | 2590 C H Arnold Rd, Saint Augustine, FL 32092 | 2016-06-14 |
| 1023467347 | Marylin Palackel James | Family Medicine | 110 Hampton Point Dr, St Augustine, FL 32092 | 2016-06-07 |
| 1790146462 | Florida Autism Center | Community/Behavioral Health | 124 Capulet Drive, St Augustine, FL 32092 | 2016-03-09 |
| 1174901458 | Kaylan Brady | Pediatrics | 70 Turin Terrace, Suite 220, St Augustine, FL 32092 | 2015-05-07 |
| 1245620368 | Angela Sanchez | Physician Assistant | 229 Adelanto Ave, St Augustine, FL 32092 | 2015-01-27 |
| 1053723700 | David Hamilton | Dentist | 149 Tuscan Way, St. Augustine, FL 32092 | 2014-05-29 |
| Find all providers in zip 32092 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568025419 | Reinventme, LLC | Surgery | 13696 N Us Highway 441 Ste 100, Lady Lake, FL 32159-6815 | 2019-04-17 |
| 1750854378 | David Gerth Md Pa | Surgery | 4308 Alton Rd Ste 940, Miami Beach, FL 33140-4560 | 2019-01-07 |
| 1588165773 | Deepak Naidu Md, Pa | Surgery | 201 E Kennedy Blvd Ste 410, Tampa, FL 33602-3641 | 2018-02-23 |
| 1194225599 | Joseph Charles Gallagher Jr. | Surgery | 9201 Midnight Pass Rd, Sarasota, FL 34242-2921 | 2018-02-13 |
| 1043729569 | Renee Gasgarth, M.d. P.a. | Surgery | 7300 Sw 62nd Pl Ste 200, South Miami, FL 33143-4800 | 2017-09-27 |
| 1184150625 | Pamela Loftus | Surgery | 4454 Woodfield Blvd, Boca Raton, FL 33434-5310 | 2017-05-03 |
| 1356898324 | Waters Edge Dermatology Global LLC | Surgery | 2601 S Kanner Highway, Stuart, FL 34994 | 2016-09-07 |
| 1629482096 | Jill Swindell | Surgery | 1921 Waldemere St Ste 801, Sarasota, FL 34239-2913 | 2014-06-13 |
| 1205274784 | Melanie L Aya-ay Md Plastic Surgery Pl | Surgery | 17523 N Dale Mabry Hwy, Lutz, FL 33548-4521 | 2013-06-06 |
| 1790123487 | Jason Crespo | Surgery | 1250 Pine Ridge Rd Ste 101c, Naples, FL 34108-8913 | 2013-06-05 |
| Find all providers with the same taxonomy | ||||
| City | ST. AUGUSTINE |
| Zip Code | 32092 |
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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.