BLACKSHEEP MEDICAL (NPI# 1770913360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770913360 |
| Entity Type | Organization |
| Organization Name | BLACKSHEEP MEDICAL |
| Practice Address |
1425 Hand Ave Suite L Ormond Beach FL 32174-1135 |
| Practice Telephone | 3862563977 |
| Practice Fax Number | 3868725004 |
| Mailing Telephone | 3862563977 |
| Mailing Fax Number | 3868725004 |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2013-11-18 |
| Authorized Official Name | DANIEL A SEEDOR (MGMR) |
| Authorized Official Telephone | 3862563977 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
| Street Address |
1425 HAND AVE SUITE L |
| City | ORMOND BEACH |
| State | FL |
| Zip Code | 32174-1135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760474399 | Richard A Jablonski | Ophthalmology | 1425 Hand Ave, Ste A, Ormond Beach, FL 32174-1135 | 2005-08-19 |
| 1558814228 | Brittany Forster | Physical Therapist | 1425 Hand Ave, Suite H, Ormond Beach, FL 32174-1135 | 2016-07-29 |
| 1124401351 | Tammy Kay Kirby | Nurse Practitioner | 1425 Hand Ave, Ormond Beach, FL 32174-1135 | 2015-07-07 |
| 1972928091 | Jamie L Morris | Physical Therapist | 1425 Hand Ave, Suite H, Ormond Beach, FL 32174-1135 | 2014-02-26 |
| 1992134712 | Blacksheep Medical LLC | Non-Pharmacy Dispensing Site | 1425 Hand Ave, Suite L, Ormond Beach, FL 32174-1135 | 2013-11-02 |
| 1164751632 | Jennifer Lynn Young | Physical Therapist | 1425 Hand Ave, Suite H, Ormond Beach, FL 32174-1135 | 2009-12-13 |
| 1528219920 | Nannine Knoerzer Dahlen | Physical Therapist | 1425 Hand Ave, Ormond Beach, FL 32174-1135 | 2008-10-02 |
| 1871759266 | Oana Mierloi Dds, Pa | Dentist | 1425 Hand Ave, Suite J, Ormond Beach, FL 32174-1135 | 2008-08-05 |
| 1801072517 | Barr & Associates Physical Therapy,llc | Clinic/Center | 1425 Hand Ave, Suite H, Ormond Beach, FL 32174 | 2008-01-11 |
| 1689863656 | Deanna K Springer M D P A | Internal Medicine | 1425 Hand Ave, Suite E, Ormond Beach, FL 32174-1135 | 2007-10-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215574991 | Case Vision Pa | Optometrist | Eye Savers, 1474 W. Granada Blvd. #470, Ormond Beach, FL 32174 | 2019-12-02 |
| 1235797143 | Galia Leilani Medrano Ramirez | Dentist | 1274 W. Granada Blvd, Ormond Beach, FL 32174 | 2019-06-05 |
| 1295299220 | Jessica Johnson Hills | Nurse Practitioner | 1400 Hand Ave Ste K, Ormond Beach, FL 32174 | 2019-01-23 |
| 1437507043 | Natasha Jairam | Family Medicine | Adventhealth Medical Group Family Medicine, 400 Clyde Morris Blvd Ste A, Ormond Beach, FL 32174 | 2016-05-25 |
| 1871956540 | Lisa Anne Parissi | Chiropractor | 157 Kimberly Drive, Ormond Beach, FL 32174 | 2016-03-31 |
| 1023477940 | Ambassador Health Services, Inc | In Home Supportive Care | 136 N Orchard St Ste 1, Ormond Beach, FL 32174 | 2016-02-19 |
| 1619341518 | Maria Rogers | Optometrist | 9 Abacus Ave, Ormond Beach, FL 32174 | 2015-11-16 |
| 1285003830 | Sydney Kalin Neuhardt | Nurse Practitioner | 725 W. Granada Blvd. Ste 1, Ormond Beach, FL 32174 | 2015-09-24 |
| 1194107821 | Jerusha Thacker | Case Manager/Care Coordinator | 259 Bill France Blvd. Ste 200, Daytona Beach, FL 32174 | 2015-06-18 |
| 1730569971 | Daniel Joseph Lapolla | Physical Therapy Assistant | 1275 Granada Blvd, Suite 4b2, Ormond Beach, FL 32174 | 2015-06-03 |
| Find all providers in zip 32174 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396398608 | Jackson Reef | Clinic/Center | 495 S Nova Rd Ste 101a, Ormond Beach, FL 32174-8444 | 2019-07-17 |
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| Find all providers with the same taxonomy | ||||
| City | ORMOND BEACH |
| Zip Code | 32174 |
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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.