PREMIER NEURO THERAPY LLC (NPI# 1770016115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770016115 |
Entity Type | Organization |
Organization Name | PREMIER NEURO THERAPY LLC |
Practice Address |
14255 Beach Blvd Jacksonville FL 32250-1576 |
Mailing Address |
13700 Sutton Park Dr N Apt. 816 Jacksonville FL 32224-2273 |
Practice Telephone | 9044700673 |
Mailing Telephone | 9044700673 |
Enumeration Date | 2017-04-04 |
Last Update Date | 2017-04-04 |
Authorized Official Name | MR. ZACHARY MICHAEL (COO/CFO) |
Authorized Official Telephone | 7173572349 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 246Z00000X | Specialist/Technologist, Other | Technologists, Technicians & Other Technical Service Providers |
Street Address |
14255 BEACH BLVD |
City | JACKSONVILLE |
State | FL |
Zip Code | 32250-1576 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053306563 | Robert Devincentis | Chiropractor | 14255 Beach Blvd, Jacksonville, FL 32250-1545 | 2005-09-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386129591 | Kelsey Ilene Keimig | Audiologist | 3200 S 3rd Street, Ste 101, Jacksonville, FL 32250 | 2018-10-03 |
1225529696 | Turning Tides Eating Disorder Treatment Center, LLC. | Clinic/Center | 4300 Marsh Landings Blvd. #101, Jacksonville Beach, FL 32250 | 2018-05-22 |
1528578820 | Dianne Frances Gay | Dental Hygienist | 1144 14th Street North, Jacksonville Beach, FL 32250 | 2017-10-02 |
1801324280 | Kailo Nutrition | Dietitian, Registered | 353 B 6th Street South, Jacksonville, FL 32250 | 2017-05-30 |
1275985368 | Shankeertha Sundaralingam | Dentist | 3316 3rd St S Ste 101, Jacksonville Beach, FL 32250 | 2016-07-13 |
1851777494 | Brooke Worthington Davidson | Audiologist | 1370 13th Ave S Ste 115, Jacksonville Beach, FL 32250 | 2015-08-05 |
1689059115 | Jenna Levine | Speech-Language Pathologist | 779 10th Avenue South, Jacksonville Beach, FL 32250 | 2015-07-27 |
1790176824 | Olivia Ingram Caswell | Acupuncturist | 2902 Isabella Boulevard, Suite 50, Jacksonville Beach, FL 32250 | 2015-02-11 |
1467859033 | Colleen Freeman | Physical Therapist | 1537 Penman Rd, Jacksonville, FL 32250 | 2014-11-26 |
1356750012 | Madelyn Jones | Physical Therapist | 1320 Roberts Drive, Jacksonville Beach, FL 32250 | 2014-08-07 |
Find all providers in zip 32250 |
Taxonomy Code | 246Z00000X |
Grouping | Technologists, Technicians & Other Technical Service Providers |
Classification | Specialist/Technologist, Other |
General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508114406 | Loy P Scruggs Jr. | Specialist/Technologist, Other | 3313 County Road 4216, Jacksonville, TX 75766-7334 | 2012-08-27 |
1821614389 | Megan L Minser | Specialist/Technologist, Other | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-06-22 |
1821623000 | Kevin Reid Scyoc | Specialist/Technologist, Other | 461 Western Blvd Ste 122, Jacksonville, NC 28546-7637 | 2020-03-07 |
1306483425 | Evonna Almtanious | Specialist/Technologist, Other | 6410 Beach Blvd, Jacksonville, FL 32216-2813 | 2019-12-09 |
1154801496 | Kelsea Mitchell | Specialist/Technologist, Other | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2018-08-16 |
1972014546 | Emily Ann Krieg | Specialist/Technologist, Other | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2017-10-23 |
1295195758 | Rebecca Riemer | Specialist/Technologist, Other | 2227 West Main Street, Suite 3, Jacksonville, AR 72076 | 2016-02-26 |
1881090983 | Jessie Battles | Specialist/Technologist, Other | 2227 W Main St Ste 3, Jacksonville, AR 72076-4251 | 2014-11-17 |
1295131399 | Misty Angelique Roetzel | Specialist/Technologist, Other | 2227 W Main St, Suite 3, Jacksonville, AR 72076-4207 | 2014-11-17 |
1972898146 | Barbara Casey Medlin | Specialist/Technologist, Other | 714 New Bridge St, Jacksonville, NC 28540-5435 | 2011-06-15 |
Find all providers in JACKSONVILLE |
City | JACKSONVILLE |
Zip Code | 32250 |
Please comment or provide details below to improve the information on PREMIER NEURO THERAPY LLC.
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.