MR. KEITH ALLEN CONGER


Address: 120 King Street, Jacksonville, FL 32204
Phone: 9042532785

MR. KEITH ALLEN CONGER (NPI# 1629029582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629029582
Entity Type Individual
Full Name MR. KEITH ALLEN CONGER
Credential ARNP
Practice Address 120 King Street
Jacksonville
FL 32204
Mailing Address 900 University Blvd. North
Mc 75
Jacksonville
FL 32211
Practice Telephone 9042532785
Practice Fax Number 9042531961
Mailing Telephone 9042532062
Mailing Fax Number 9042531942
Enumeration Date 2006-05-15
Last Update Date 2012-12-27
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
ARNP2854262 FL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL 305137400 05
FL 3051374-00 05

Office Location

Street Address 120 KING STREET
City JACKSONVILLE
State FL
Zip Code 32204

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1336529817 Nader Daoud Internal Medicine 1 Shircliffway, Jacksonville, FL 32204 2015-06-01
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1881293868 Maria Fe Guboc Rufano-sulit Nurse Practitioner 3682 Summerlin Ln, Jacksonville, FL 32224-1650 2020-10-21
1346849502 Caitlin Flott Nurse Practitioner 14589 Camberwell Ln S, Jacksonville, FL 32258-1708 2020-10-20
1972101137 Amanda Brooke Mills Nurse Practitioner 8459 Oak Crossing Dr W, Jacksonville, FL 32244-6949 2020-10-10
1649877200 Shalom Barile Nurse Practitioner 1377 Ingleside Ave, Jacksonville, FL 32205-7733 2020-10-07
1013524248 Claudia Joseph Nurse Practitioner 3331 Net Ct, Jacksonville, FL 32277-2735 2020-10-01
1063029577 Erica Francisca Andrade Nurse Practitioner 5475 Turkey Creek Rd, Jacksonville, FL 32244-8549 2020-09-29
1568078418 Jennifer Ruth Woodard Nurse Practitioner 29 Trinity Way, Jacksonville, AL 36265-5813 2020-09-16
1013522309 William David Michal Nurse Practitioner 4417 Chippewa Dr, Jacksonville, FL 32210-6006 2020-09-13
1063025906 Fabiola Baptiste Nurse Practitioner 9143 Philips Hwy Ste 110, Jacksonville, FL 32256-1365 2020-08-29
1295348464 Debi Cohen Nurse Practitioner 11266 Cloverhill Ct, Jacksonville, FL 32257-1438 2020-08-27
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Competitor

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City JACKSONVILLE
Zip Code 32204

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Dataset Information

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.

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