MR. JENNINGS E. MOONEYHAN (NPI# 1790107928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790107928 |
| Entity Type | Individual |
| Full Name | MR. JENNINGS E. MOONEYHAN |
| Other Name | MR. JENNINGS E MOONEYHAN |
| Credential | SA-C |
| Practice Address |
1310 1st St S Jacksonville Beach FL 32250-6404 |
| Practice Telephone | 9042225491 |
| Practice Fax Number | 9046271609 |
| Mailing Telephone | 9042225491 |
| Mailing Fax Number | 9046271609 |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2014-01-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
94-122 | TN | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
1310 1ST ST S |
| City | JACKSONVILLE BEACH |
| State | FL |
| Zip Code | 32250-6404 |
| 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 | 246ZC0007X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Surgical Assistant |
| A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training. |
| Notes: Source: Association of Surgical Assistants, 2014. [7/1/2014: title modified, definition modified] http://www.surgicalassistant.org/index.php/surgical-assisting Additional Resources: National Surgical Assistant Association, www.nsaa.net. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275349 | Ydalina Inmaculada Coste Jimenez | Specialist/Technologist, Other | 6817 College Ct Apt 103, Davie, FL 33317-7169 | 2020-11-07 |
| 1508467374 | Anthony Arias Bravo | Specialist/Technologist, Other | 2380 Fairmont Ave, Miramar, FL 33025-3818 | 2020-11-06 |
| 1831798206 | Yanosit Garcia | Specialist/Technologist, Other | 7945 W 31st Ct, Hialeah, FL 33018-3852 | 2020-10-18 |
| 1043819485 | Vivian Martin | Specialist/Technologist, Other | 3401 Sw 10th St Apt 4, Miami, FL 33135-4431 | 2020-10-17 |
| 1891394243 | Tami Coromoto Fort | Specialist/Technologist, Other | 3433 Garden Ave Apt 4, Miami Beach, FL 33140-3847 | 2020-10-17 |
| 1144829581 | Diana Carolina Villalba Pena | Specialist/Technologist, Other | 555 S Luna Ct Apt 111, Hollywood, FL 33021-7564 | 2020-10-17 |
| 1871192211 | Luis Enrique Perez Sanchez | Specialist/Technologist, Other | 15411 Sw 77th Circle Ln Apt 205, Miami, FL 33193-1823 | 2020-10-17 |
| 1598376493 | Melissa Croskey | Specialist/Technologist, Other | 7271 Bucks Ford Dr, Riverview, FL 33578-8379 | 2020-08-13 |
| 1114545498 | Genesis Navas | Specialist/Technologist, Other | 1330 Coral Way Ste 306, Miami, FL 33145-2945 | 2020-07-13 |
| 1629696786 | Indhira Y Pena | Specialist/Technologist, Other | 20 Commodore Dr Apt 114, Plantation, FL 33325-2676 | 2020-07-06 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE BEACH |
| Zip Code | 32250 |
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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.