KERRY VAUGHN RIFKIN (NPI# 1730134644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730134644 |
| Entity Type | Individual |
| Full Name | KERRY VAUGHN RIFKIN |
| Credential | M.D. |
| Practice Address |
2140 Kingsley Ave Suite 14 Orange Park FL 32073-5180 |
| Practice Telephone | 9042767997 |
| Practice Fax Number | 9042767559 |
| Mailing Telephone | 9042767997 |
| Mailing Fax Number | 9042767559 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2020-03-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
G4046 | TX | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
ME0041529 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 067441900 | 05 | |
| FL | RAILROAD MEDICARE | 020016680 | 01 |
| FL | BCBS OF FLORIDA | 15764 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1500 S Main St, Fort Worth, TX 761044917 | 8177023431 | 8179273603 |
| Street Address |
2140 KINGSLEY AVE SUITE 14 |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-5180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245239607 | James Roy Biggerstaff | Family Medicine | 2140 Kingsley Ave, Orange Park, FL 32073-5180 | 2005-07-19 |
| 1063995306 | Carissa Aquino | Specialist/Technologist | 2140 Kingsley Ave, Orange Park, FL 32073-5180 | 2018-09-12 |
| 1265982045 | Garrett Randall Johnson | Physical Therapist | 2140 Kingsley Ave, Orange Park, FL 32073-5180 | 2016-10-05 |
| 1710432455 | Nicole Mills | Physical Therapist | 2140 Kingsley Ave, Suite 5, Orange Park, FL 32073-5180 | 2016-08-23 |
| 1891121851 | Rebecca Anne Weir | Physical Therapy Assistant | 2140 Kingsley Ave, Suite 5, Orange Park, FL 32073-5144 | 2013-09-23 |
| 1427397264 | Orange Park Acute Trauma,llc | Surgery | 2140 Kingsley Ave, Suite 14, Orange Park, FL 32073-5180 | 2013-02-13 |
| 1588909659 | Amanda Jeanette Shinko | Physician Assistant | 2140 Kingsley Ave, Suite 1, Orange Park, FL 32073-5180 | 2012-11-30 |
| 1902188923 | Rick Albarran | Nurse Practitioner | 2140 Kingsley Ave, Orange Park, FL 32073-5180 | 2011-09-15 |
| 1861790404 | Amber Lynn Thomas | Nurse Practitioner | 2140 Kingsley Ave, Suite 14, Orange Park, FL 32073-5180 | 2011-03-07 |
| 1932421716 | Solantic Urgent Care | Pharmacy | 2140 Kingsley Ave, Orange Park, FL 32073-5180 | 2010-02-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104394857 | George Scott Hall Sr. | Surgery | 9 Marsh Creek Rd, Fernandina Beach, FL 32034-6413 | 2018-11-09 |
| 1316413115 | Fox Vascular Experts, LLC | Surgery | 2699 Stirling Rd Ste A301302, Fort Lauderdale, FL 33312-6517 | 2018-10-18 |
| 1114417508 | Vascular Center of Naples Inc. | Surgery | 5490 Bryson Dr Ste 201, Naples, FL 34109 | 2018-05-11 |
| 1598267593 | Joseph D Stillword, Md | Surgery | 800 Zeagler Dr Ste 320, Palatka, FL 32177-3827 | 2018-03-06 |
| 1386157006 | Beatriz Lam | Surgery | 2001 West 68 St, Cvicu, Hialeah, FL 33016 | 2017-11-16 |
| 1811421092 | Sunrise Vascular Center | Surgery | 8555 Nw 165th Ter, Miami Lakes, FL 33016-6138 | 2017-04-14 |
| 1962891838 | Global Trauma Systems, Inc | Surgery | 126 Se Mira Lavella, Port Saint Lucie, FL 34984-6615 | 2015-01-15 |
| 1184013450 | Vas-q-lar, Inc | Surgery | 6187 Nw 167th St, Suite H13, Hialeah, FL 33015-4340 | 2015-01-09 |
| 1396147138 | Usa Vein Clinics of Miami, LLC | Surgery | 1711 E Hallandale Beach Blvd Ste B, Hallandale Beach, FL 33009-4621 | 2014-09-24 |
| 1114336021 | Florida Vein Center, Inc | Surgery | 6050 53rd Ave E Unit A, Bradenton, FL 34203-9700 | 2014-08-05 |
| Find all providers with the same taxonomy | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
Please comment or provide details below to improve the information on KERRY VAUGHN RIFKIN.
| 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.