GERISOURCE (NPI# 1871894972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871894972 |
| Entity Type | Organization |
| Organization Name | GERISOURCE |
| Practice Address |
11812 Crusselle Dr Jacksonville FL 32223-0876 |
| Practice Telephone | 9042525265 |
| Mailing Telephone | 9042525265 |
| Enumeration Date | 2010-11-06 |
| Last Update Date | 2010-11-06 |
| Authorized Official Name | MRS. ANDREA H CLAYMAN (PRESIDENT) |
| Authorized Official Telephone | 9042525265 |
| Authorized Official Credential | ARNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
9260038 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11812 CRUSSELLE DR |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32223-0876 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114926037 | Andrea H Clayman | Nurse Practitioner | 11812 Crusselle Dr, Jacksonville, FL 32223-0876 | 2005-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679103600 | Karen Gabriela Alexander | Dietitian, Registered | Ackerman Cancer Center, 10881 San Jose Blvd, Jacksonville, FL 32223 | 2020-01-17 |
| 1891250049 | Thalia L Honea | Occupational Therapist | 12766 San Jose Blvd, Suite 716 & 717, Jacksonville, FL 32223 | 2019-02-01 |
| 1447758289 | Stephanie Ann Murphy | Marriage & Family Therapist | 11543 Halethorpe Drive, Jacksonville, FL 32223 | 2018-01-26 |
| 1861948481 | Nicole Gay | Developmental Therapist | 12276 San Jose Blvd, Ste 5, Jacksonville, FL 32223 | 2016-09-01 |
| 1740694439 | Robyn K Mizelle | Behavioral Analyst | 12276 San Jose Blvd. Great Strides Rehabilitation, Suite 507, Jacksonville, FL 32223 | 2014-06-20 |
| 1184038010 | Kelli Anne Cabrera | Occupational Therapist | 12350 San Jose Blvd, Jacksonville, FL 32223 | 2014-06-18 |
| 1891031910 | Mandarin Family Medicine, P.a. | Preferred Provider Organization | 12276-210 San Jose Blvd, Jacksonville, FL 32223 | 2012-12-18 |
| 1114201811 | Darshana Choksi | Pharmacist | 3663 Marbon Rd, Jacksonville, FL 32223 | 2011-09-30 |
| 1346539988 | Harris Wilcox and Donovan Pa | Optometrist | 11790 San Jose Bl, Jacksonville, FL 32223 | 2011-04-05 |
| 1740517796 | Beth A. Kelley | Occupational Therapist | 2640 Scott Mill Dr, Jacksonville, FL 32223 | 2009-11-12 |
| Find all providers in zip 32223 | ||||
| Taxonomy Code | 363LG0600X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Gerontology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265081517 | Patsy Taylor | Nurse Practitioner | 8518 Julia Marie Cir, Jacksonville, FL 32210-0412 | 2019-09-10 |
| 1801449624 | Jamie Lea Laakmann | Nurse Practitioner | 14890 Bartram Creek Blvd, Jacksonville, FL 32259-7044 | 2019-07-21 |
| 1003312539 | Michael Eric Bristow | Nurse Practitioner | 11481 Old Saint Augustine Rd Ste 303, Jacksonville, FL 32258-1476 | 2018-04-03 |
| 1982159190 | Dena Alexander | Nurse Practitioner | 12015 Stacy Scott Ct, Jacksonville, FL 32223-0780 | 2016-08-17 |
| 1871820159 | Kay Frances Fullwood | Nurse Practitioner | 2345 Luana Dr E, Jacksonville, FL 32246-9561 | 2009-11-08 |
| 1023048147 | Laura J Rowe | Nurse Practitioner | 3599 University Blvd. South, Jacksonville, FL 32216 | 2006-07-04 |
| 1871581660 | Lolita Condino Massengill | Nurse Practitioner | 6665 Banbury Road, Jacksonville, FL 32211 | 2005-10-06 |
| 1114926037 | Andrea H Clayman | Nurse Practitioner | 11812 Crusselle Dr, Jacksonville, FL 32223-0876 | 2005-07-21 |
| 1467088724 | Mary Joy Castro Whitmire | Nurse Practitioner | 655 W 8th St, Jacksonville, FL 32209-6511 | 2020-03-19 |
| 1386120087 | Heidi Diane Brown | Nurse Practitioner | 915 W Monroe St Ste 200, Jacksonville, FL 32204-1177 | 2018-07-16 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32223 |
Please comment or provide details below to improve the information on GERISOURCE.
| 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.