PHYSICIAN PROVIDERS GROUP PA (NPI# 1720073216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720073216 |
| Entity Type | Organization |
| Organization Name | PHYSICIAN PROVIDERS GROUP PA |
| Other Organization Name | COMPREHENSIVE PAIN MANAGEMENT CENTER |
| Practice Address |
305 S Line Ave Inverness FL 34452-4605 |
| Mailing Address |
16380 Se 84th Ct Summerfield FL 34491-7057 |
| Practice Telephone | 3523444791 |
| Practice Fax Number | 3523443822 |
| Mailing Telephone | 3527500236 |
| Mailing Fax Number | 8887703208 |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2020-08-11 |
| Authorized Official Name | ROBERT ULSETH (MD/OWNER) |
| Authorized Official Telephone | 3523444791 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE SHIELD PROV # | 34759 | 01 |
| Other Name | Type Code |
|---|---|
| COMPREHENSIVE PAIN MANAGEMENT CENTER | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3120 Sw 27th Ave, Suite 300, Ocala, FL 344718958 | 3522363025 | 3522363521 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396200283 | Physician Providers Group Pa | Specialist | 3120 Sw 27th Ave Ste 300, Ocala, FL 34471-8984 | 2019-02-05 |
| Street Address |
305 S LINE AVE |
| City | INVERNESS |
| State | FL |
| Zip Code | 34452-4605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447258488 | Dale L Osterling | Obstetrics & Gynecology | 305 S Line Ave, Inverness, FL 34452-4605 | 2005-07-13 |
| 1932766334 | Amy L Dixon | Nurse Practitioner | 305 S Line Ave, Inverness, FL 34452-4605 | 2019-05-22 |
| 1336560184 | Rebecca Lynne Ferguson | Nurse Practitioner | 305 S Line Ave, Inverness, FL 34452-4605 | 2013-12-20 |
| 1639436264 | Danny Joe Mclaughlin | Physician Assistant | 305 S Line Ave, Inverness, FL 34452-4605 | 2012-04-20 |
| 1326353699 | Kimberly Bertha Monaski | Nurse Practitioner | 305 S Line Ave, Inverness, FL 34452-4605 | 2010-08-11 |
| 1609014406 | Kathleen S Jenkins | Nurse Practitioner | 305 S Line Ave, Inverness, FL 34452-4605 | 2009-02-02 |
| 1356460638 | Indra B Ramdayal | Nurse Practitioner | 305 S Line Ave, Inverness, FL 34452-4605 | 2007-03-28 |
| 1750333209 | Kenneth Lemos | Physician Assistant | 305 S Line Ave, Inverness, FL 34452-4605 | 2006-05-16 |
| 1891744694 | Robert Ulseth LLC | Specialist | 305 S Line Ave, Inverness, FL 34452-4605 | 2006-05-09 |
| 1043205305 | Robert Ulseth | Specialist | 305 S Line Ave, Inverness, FL 34452-4605 | 2005-09-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528680204 | Medical Risk Solutions LLC | Family Medicine | 216-c South Apopka Ave., Inverness, FL 34452 | 2020-05-15 |
| 1801354204 | Mari Parker | Nurse Practitioner | 520 W Highland Blvd, Inverness, FL 34452 | 2019-03-05 |
| 1346737061 | Sharma Institute of Pain Medicine | Physical Medicine & Rehabilitation | 211 South Seminole Ave, Inverness, FL 34452 | 2018-04-18 |
| 1548779846 | Alexandra Weinmann | Behavior Technician | 6765 E Kingsbury Lane, Inverness, FL 34452 | 2017-09-29 |
| 1821536913 | Mechelle Louise Lewis | Nurse Practitioner | 212 S. Pine Avenue, Inverness, FL 34452 | 2017-02-08 |
| 1639615131 | Elizabeth Lynch | Behavioral Analyst | 609 Goodyear Ave, Inverness, FL 34452 | 2017-01-09 |
| 1942511100 | Families Come First, LLC | In Home Supportive Care | 220 S Pine Ave, Invenress, FL 34452 | 2010-06-23 |
| 1639342470 | Assisted Living Concepts Inc | Assisted Living Facility | 700 Medical Court East, Inverness, FL 34452 | 2008-04-11 |
| 1063684686 | Winn-dixie Stores, Inc. | Durable Medical Equipment & Medical Supplies | 333 Highland Ave Space 600, Inverness, FL 34452 | 2008-03-25 |
| 1831372606 | Gira S. Shah, Md, Pa | Internal Medicine | 203 S. Seminole Ave, Inverness, FL 34452 | 2007-12-14 |
| Find all providers in zip 34452 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427490614 | Kathryn L Menis | Specialist | 1731 Galloway Cir, Inverness, IL 60010-5718 | 2013-07-29 |
| 1598805749 | Craig W. Englund, Md, Pa | Specialist | 801 Medical Ct E, Inverness, FL 34452-4623 | 2007-02-07 |
| 1134124951 | Charles Alexander Prentice | Specialist | 214 S Pine Ave, Inverness, FL 34452-4838 | 2005-06-17 |
| 1013293109 | Charles A Prentice Md Pa | Specialist | 214 S Pine Ave, Inverness, FL 34452-4838 | 2011-11-02 |
| 1831380732 | Beena M Stanley | Specialist | 511 W Highland Blvd, Inverness, FL 34452-4719 | 2007-08-06 |
| 1215156179 | Genesis Womens Center Pa | Specialist | 800 Medical Ct E, Inverness, FL 34452-4612 | 2007-04-25 |
| 1912049628 | Todd Sisto Md Pa | Specialist | 131 S Citrus Ave, Suite 307, Inverness, FL 34452-4701 | 2007-02-12 |
| 1891744694 | Robert Ulseth LLC | Specialist | 305 S Line Ave, Inverness, FL 34452-4605 | 2006-05-09 |
| 1548238389 | Thomas E Hendrick | Specialist | 403 W Highland Blvd, Inverness, FL 34452-4717 | 2006-03-09 |
| 1790752863 | Inverness Surgical Association P A | Specialist | 403 W Highland Blvd, Inverness, FL 34452-4717 | 2006-03-07 |
| Find all providers in INVERNESS | ||||
Please comment or provide details below to improve the information on PHYSICIAN PROVIDERS GROUP PA.
| 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.