PHYSICIANS GROUP SERVICES PA (NPI# 1699170035) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699170035 |
| Entity Type | Organization |
| Organization Name | PHYSICIANS GROUP SERVICES PA |
| Other Organization Name | COASTAL SPINE AND PAIN CENTER |
| Practice Address |
13241 Bartram Park Blvd Suite 1101 Jacksonville FL 32258-5212 |
| Mailing Address |
3839 County Road 218 Middleburg FL 32068-5708 |
| Practice Telephone | 9042888311 |
| Practice Fax Number | 9042888371 |
| Mailing Telephone | 9047514906 |
| Mailing Fax Number | 9047143574 |
| Enumeration Date | 2014-10-28 |
| Last Update Date | 2014-10-29 |
| Authorized Official Name | KENT T BRAEUTIGAM (PRESIDENT) |
| Authorized Official Telephone | 9042826331 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
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 |
| 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 |
| 1821339920 | Physicians Group Services Pa | Orthopaedic Surgery | 2255 Dunn Ave, Building 100, Jacksonville, FL 32218-4719 | 2013-03-14 |
| Street Address |
13241 BARTRAM PARK BLVD SUITE 1101 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32258-5212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306833587 | Mark Andrew Matey | Podiatrist | 13241 Bartram Park Blvd, Suite 1809, Jacksonville, FL 32258-5227 | 2005-10-03 |
| 1942808977 | Etleva Iliazi | Nurse Practitioner | 13241 Bartram Park Blvd, Jacksonville, FL 32258-5212 | 2020-10-12 |
| 1952830093 | Lauren Kessenich | Nurse Practitioner | 13241 Bartram Park Blvd, Jacksonville, FL 32258-5212 | 2017-06-11 |
| 1497295505 | Blayne O Yerby | Physician Assistant | 13241 Bartram Park Blvd, Suite 209, Jacksonville, FL 32258-5212 | 2017-03-08 |
| 1366981904 | Jennifer Mooney | Nurse Practitioner | 13241 Bartram Park Blvd, Suite 209, Jacksonville, FL 32258-5212 | 2017-02-15 |
| 1902344427 | Raquel S Watkins Md Pllc | Allergy & Immunology | 13241 Bartram Park Blvd, Suite 2601, Jacksonville, FL 32258-5212 | 2017-02-03 |
| 1457805756 | Pediatric Innovation Center, LLC | Pediatrics | 13241 Bartram Park Blvd, Suite 209, Jacksonville, FL 32258-5212 | 2016-08-04 |
| 1386097442 | Khoi M Le | Dentist | 13241 Bartram Park Blvd, Ste. 1705, Jacksonville, FL 32258-5212 | 2016-07-13 |
| 1629453246 | Julian Bungubung | Nurse Practitioner | 13241 Bartram Park Blvd, Suite 413, Jacksonville, FL 32258-5212 | 2015-07-24 |
| 1023496189 | Railing Chiropractic & Acupuncture | Chiropractor | 13241 Bartram Park Blvd, 509, Jacksonville, FL 32258-5212 | 2015-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437794237 | Nicoleta Descalzo | Behavior Technician | 12724 Grand Bay Parkway West, Suite 410, Jacksonville, FL 32258 | 2019-11-15 |
| 1992275572 | William Lundgren | Nurse Anesthetist, Certified Registered | 3625 University Blvd South, Jacksonville, FL 32258 | 2018-11-27 |
| 1104301159 | Emergency Physicians Inc | Emergency Medicine | 14534 Old St Augustine Rd, Suite 3110, Jacksonville, FL 32258 | 2018-09-26 |
| 1679092886 | Palm Life Medical Associates Pa | Assisted Living Facility | 12494 Acosta Oaks Drive, Jacksonville, FL 32258 | 2017-09-19 |
| 1679013932 | Optometry Vision Care Pllc | Optometrist | 14866 Old St. Augustine Rd Unit 110, Jacksonville, FL 32258 | 2017-03-06 |
| 1467991950 | North Florida Vision Group Inc | Optometrist | 14866 Old St. Augustine Rd., Suite 110, Jacksonville, FL 32258 | 2017-02-16 |
| 1124576566 | Revolution Chiropractic LLC | Chiropractor | 14866 Old St Augustine Road, Suite 113, Jacksonville, FL 32258 | 2016-09-14 |
| 1396291936 | Robyn Reaves | Nurse Practitioner | 12361 Richards Glen Ct, Jacksonville, FL 32258 | 2016-09-01 |
| 1326595927 | Lauren Cost | Chiropractor | 14866 Old St. Augustine Road, Suite 113, Jacksonville, FL 32258 | 2016-09-01 |
| 1487991170 | Mark Steven Colosimo | Pharmacist | 13820 Old St Augustine Road, Jacksonville, FL 32258 | 2013-01-15 |
| Find all providers in zip 32258 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1912219064 | Emed Multispecialty Group Pa | Pain Medicine | 2624 Atlantic Boulevard, Jacksonville, FL 32204 | 2010-07-06 |
| 1013967561 | Thomas Van Holland | Pain Medicine | 5834 Normandy Blvd, Jacksonville, FL 32205-6253 | 2006-05-12 |
| 1710948856 | Gerardo Florez | Pain Medicine | 1755 University Blvd W, Jacksonville, FL 32217-2009 | 2006-03-29 |
| 1407822067 | Michael James Lupi | Pain Medicine | 11705 San Jose Blvd Ste 110, Jacksonville, FL 32223 | 2006-02-24 |
| 1720609381 | Guardian Medical Care Pllc | Pain Medicine | 943 Cesery Blvd Ste G, Jacksonville, FL 32211-5655 | 2020-05-05 |
| 1508355181 | Integrated Pain Services Inc | Pain Medicine | 4063 Salisbury Rd, Jacksonville, FL 32216-8030 | 2018-05-09 |
| 1154563591 | Courtney Melton Auman | Pain Medicine | 57 Office Park Dr, Jacksonville, NC 28546-7327 | 2009-03-31 |
| 1134282296 | Marla D Golden Do Pa | Pain Medicine | 6817 Southpoint Pkwy, Suite 1404, Jacksonville, FL 32216-6282 | 2006-12-19 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32258 |
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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.