PHYSICIANS GROUP SERVICES PA (NPI# 1649584079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649584079 |
| Entity Type | Organization |
| Organization Name | PHYSICIANS GROUP SERVICES PA |
| Other Organization Name | COASTAL SPINE AND PAIN CENTER |
| Practice Address |
1865 Lime St Suite 101 Fernandina Beach FL 32034-4744 |
| Mailing Address |
3839 County Road 218 Middleburg FL 32068-5708 |
| Practice Telephone | 9043212422 |
| Practice Fax Number | 9043212434 |
| Mailing Telephone | 9042826331 |
| Mailing Fax Number | 9042120346 |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2013-08-27 |
| Authorized Official Name | KENT T. BRAEUTIGAM (PRESIDENT) |
| Authorized Official Telephone | 9042826331 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 259123500 | 05 |
| Other Name | Type Code |
|---|---|
| Coastal Spine and Pain Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841674314 | Physicians Group Services Pa | Pediatrics | 421 Kingsley Ave Ste 300, Orange Park, FL 32073-4898 | 2015-07-15 |
| 1861440810 | Physicians Group Services Pa | Nurse Practitioner | 3839 County Road 218, Middleburg, FL 32068-5708 | 2006-05-04 |
| 1932682986 | Physicians Group Services Pa | Clinic/Center | 421 Kingsley Ave Ste 400, Orange Park, FL 32073-4898 | 2018-09-14 |
| 1497118160 | Physicians Group Services Pa | Family Medicine | 14810 Old Saint Augustine Rd, Suite 207, Jacksonville, FL 32258-2451 | 2016-03-31 |
| 1699138362 | Physicians Group Services Pa | Family Medicine | 1689 Eagle Harbor Pkwy, Suite A, Fleming Island, FL 32003-4817 | 2016-03-31 |
| 1962860619 | Physicians Group Services Pa | Podiatrist | 3839 County Road 218, Middleburg, FL 32068-5708 | 2016-02-09 |
| 1952706368 | Physicians Group Services Pa | Family Medicine | 2700 Riverside Ave, Suite 2, Jacksonville, FL 32205-8275 | 2014-10-28 |
| 1699170035 | Physicians Group Services Pa | Family Medicine | 13241 Bartram Park Blvd, Suite 1101, Jacksonville, FL 32258-5212 | 2014-10-28 |
| 1831530658 | Physicians Group Services Pa | Family Medicine | 421 Kingsley Ave, Orange Park, FL 32073-4897 | 2013-07-09 |
| 1598105686 | Physicians Group Services Pa | Family Medicine | 6816 Southpoint Pkwy, Suite 102, Jacksonville, FL 32216-1700 | 2013-07-03 |
| Street Address |
1865 LIME ST SUITE 101 |
| City | FERNANDINA BEACH |
| State | FL |
| Zip Code | 32034-4744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811057318 | Timothy D Lucey | Psychiatry & Neurology | 1865 Lime St, Suite 103, Fernandina Beach, FL 32034-4779 | 2006-12-12 |
| 1265861595 | Ida Brown | Counselor | 1865 Lime St, Suite 101, Fernandina Beach, FL 32034-4779 | 2013-11-07 |
| 1912223108 | Eugene Wang | Psychiatry & Neurology | 1865 Lime St, Suite 101, Fernandina Beach, FL 32034-4779 | 2010-04-13 |
| 1477719656 | Timothy Lucey Do Pllc | Psychiatry & Neurology | 1865 Lime St, Suite 103, Fernandina Beach, FL 32034-4779 | 2008-08-06 |
| 1619180411 | Carly J Miller | Psychiatry & Neurology | 1865 Lime St, Suite 100, Fernandina Beach, FL 32034-4744 | 2007-05-08 |
| 1750400792 | Alan Edward Miller | Physical Medicine & Rehabilitation | 1865 Lime St, Suite 101, Fernandina Beach, FL 32034-4744 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871059899 | Anna Fn Chu | Dietitian, Registered | Baptist Medical Center Nassau, 1250 South 18th Street, Fernandina Beach, FL 32034 | 2019-02-14 |
| 1841784550 | Kelly Ann Sayers | Social Worker | 1890 S 14th St Ste 110, Fernandina Beach, FL 32034 | 2018-06-15 |
| 1609302611 | Christian Giovanniello | Behavior Technician | 1743 Azalea Street, Fernandina Beach, FL 32034 | 2017-05-11 |
| 1770018467 | Beckerton Chiropractic Pllc | Chiropractor | 464073 East State Road 200, Yulee, FL 32034 | 2017-05-01 |
| 1114392438 | Jayde Marie Gray | Chiropractor | 5211 South Fletcher Ave., Suite 250, Amelia Island, FL 32034 | 2015-12-11 |
| 1760858369 | Sun Gallery Inc. | Eyewear Supplier (Equipment, not the service) | 1523 Sadler Road, Fernandina Beach, FL 32034 | 2015-08-18 |
| 1124419718 | Angela L Michels | Counselor | 1890 S. 14th St., #302, Fernandina Beach, FL 32034 | 2015-02-18 |
| 1336542075 | Sara Veronica Herreros | Physician Assistant | 1865 Lime Street, Suite 100, Fernandina Beach, FL 32034 | 2014-10-08 |
| 1366789471 | Elizabeth Ann Moore | Nurse Practitioner | 1348 S 18th St Ste 340, Fernandina Beach, FL 32034 | 2013-01-09 |
| 1043564289 | Summer Suzanne Delille | Dental Hygienist | 95054 Oriole St., Fernandina Beach, FL 32034 | 2012-11-08 |
| Find all providers in zip 32034 | ||||
| Taxonomy Code | 208VP0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Pain Medicine |
| Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient’s pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies. |
| Notes: Source: American Academy of Pain Medicine, www.painmed.org - Additional Resources:The American Board of Pain Medicine provides Board Certification. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306452115 | Premier Pain and Wellness LLC | Pain Medicine | 12555 Sw 46th St, Miami, FL 33175-4725 | 2020-09-17 |
| 1861043929 | Spine Center of Fl LLC | Pain Medicine | 9400 Bonita Beach Rd Se Ste 101, Bonita Springs, FL 34135-4520 | 2019-09-20 |
| 1356998975 | Haitao Zhang Md, P.a. | Pain Medicine | 3688 Burnt Pine Dr, Jacksonville, FL 32224-0870 | 2019-08-19 |
| 1013487362 | Florida Institute of Pain Medicine LLC | Pain Medicine | 2386 Dunn Ave Ste 111, Jacksonville, FL 32218-4751 | 2018-11-29 |
| 1619442209 | Family Spine and Pain Care Institute LLC | Pain Medicine | 1525 Tamiami Trl S Ste 601, Venice, FL 34285-3568 | 2018-10-10 |
| 1215429717 | Pain Treatment Specialists | Pain Medicine | 2601 E Oakland Park Blvd Ste 200, Fort Lauderdale, FL 33306 | 2018-05-31 |
| 1164912754 | Superior Physician Group | Pain Medicine | 10730 N 56th St Ste 209, Temple Terrace, FL 33617 | 2018-05-18 |
| 1568977973 | Prc Associates, LLC | Pain Medicine | 1545 Hand Ave Ste Az, Ormond Beach, FL 32174-1139 | 2017-12-07 |
| 1710406228 | Sasha Saidi | Pain Medicine | 16810 South Highway 441, Suite 502, Summerfield, FL 34491 | 2017-09-15 |
| 1003341280 | Yvonne Derickson | Pain Medicine | 105 Whitehall Dr Ste 115-116, St Augustine, FL 32086-5269 | 2017-04-26 |
| Find all providers with the same taxonomy | ||||
| City | FERNANDINA BEACH |
| Zip Code | 32034 |
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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.