PHYSICIANS GROUP SERVICES (NPI# 1881089613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881089613 |
| Entity Type | Organization |
| Organization Name | PHYSICIANS GROUP SERVICES |
| Other Organization Name | COASTAL SPINE AND PAIN CENTER |
| Practice Address |
11555 Central Pkwy Ste 304 Jacksonville FL 32224-2694 |
| Mailing Address |
3839 County Road 218 Middleburg FL 32068-5708 |
| Practice Telephone | 9042826331 |
| Practice Fax Number | 9042821550 |
| Mailing Telephone | 9042657755 |
| Mailing Fax Number | 9042657754 |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2015-03-30 |
| Authorized Official Name | KENT T BRAEUTIGAM (PRESIDENT) |
| Authorized Official Telephone | 9042826331 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 259123500 | 05 |
| Other Name | Type Code |
|---|---|
| Coastal Spine and Pain Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003288358 | Physicians Group Services | Internal Medicine | 1542 Kingsley Ave Ste 139, Orange Park, FL 32073-4547 | 2015-10-27 |
| 1144568262 | Physicians Group Services | Family Medicine | 14011 Beach Blvd, Suite 120, Jacksonville, FL 32250-1507 | 2013-01-24 |
| 1508104746 | Physicians Group Services | Family Medicine | 1050 Riverside Ave, Suite B, Jacksonville, FL 32204-4123 | 2013-01-23 |
| 1396013702 | Physicians Group Services | Internal Medicine | 2334 S 8th St, Fernandina Beach, FL 32034-1979 | 2011-12-13 |
| Street Address |
11555 CENTRAL PKWY STE 304 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32224-2694 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912979584 | Jeffrey Michael Green | Physician Assistant | 11555 Central Pkwy Ste 304, Jacksonville, FL 32224-2694 | 2006-02-07 |
| 1487270351 | Formoso Pain Specialists, Pa | Pain Medicine | 11555 Central Pkwy Ste 304, Jacksonville, FL 32224-2694 | 2020-06-17 |
| 1396007993 | Andrew David Green | Nurse Practitioner | 11555 Central Pkwy Ste 304, Jacksonville, FL 32224-2694 | 2012-06-11 |
| 1346554771 | Physicians Group Services Pa | Family Medicine | 11555 Central Pkwy Ste 304, Jacksonville, FL 32224-2694 | 2010-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974372 | Noelle Parker | Specialist/Technologist | 1 Unf Drivve, Jacksonville, FL 32224 | 2020-02-18 |
| 1124685102 | Charcy Rene Stiller | Specialist/Technologist | 1 Unf Dr., Jacksonville, FL 32224 | 2019-05-24 |
| 1265097513 | Mayo Clinic Jacksonville | Ambulance | 13970 Zumbro Dr, Jacksonville, FL 32224 | 2019-05-02 |
| 1639681471 | Brigantti Anesthesia & Spine Care | Clinic/Center | 1361 13th Ave South Suite #210, Jacksonville, FL 32224 | 2017-11-02 |
| 1093240061 | Beric Emilio Berlioz | Anesthesiology | 4500 San Pablo Rd S # J, Jacksonville, FL 32224 | 2017-04-26 |
| 1609240746 | Matthew James Dailey | Nurse Anesthetist, Certified Registered | 2500 San Pablo Rd S, Jacksonville, FL 32224 | 2015-11-29 |
| 1003299603 | Upscale Personal Care Home | Assisted Living Facility | 4375 Autumn River Road, Jacksonville, FL 32224 | 2015-07-01 |
| 1629459375 | Bellanid Fonseca | Social Worker | 3694 Summerlin Ln E, Jacksonville, FL 32224 | 2015-06-17 |
| 1164840500 | Nicholas Scotto | Physical Therapist | 11555 Central Pkwy Ste 1104, Jacksonville, FL 32224 | 2014-04-02 |
| 1497093454 | Quicker Care Urgent Care | Point of Service | 13770 Beach Blvd., Unit # 4, Jacksonville, FL 32224 | 2013-01-27 |
| Find all providers in zip 32224 | ||||
| Taxonomy Code | 208VP0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Pain Medicine |
| Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient’s pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies. |
| Notes: Source: American Academy of Pain Medicine, www.painmed.org - Additional Resources:The American Board of Pain Medicine provides Board Certification. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356998975 | Haitao Zhang Md, P.a. | Pain Medicine | 3688 Burnt Pine Dr, Jacksonville, FL 32224-0870 | 2019-08-19 |
| 1013487362 | Florida Institute of Pain Medicine LLC | Pain Medicine | 2386 Dunn Ave Ste 111, Jacksonville, FL 32218-4751 | 2018-11-29 |
| 1912219064 | Emed Multispecialty Group Pa | Pain Medicine | 2624 Atlantic Boulevard, Jacksonville, FL 32204 | 2010-07-06 |
| 1013967561 | Thomas Van Holland | Pain Medicine | 5834 Normandy Blvd, Jacksonville, FL 32205-6253 | 2006-05-12 |
| 1710948856 | Gerardo Florez | Pain Medicine | 1755 University Blvd W, Jacksonville, FL 32217-2009 | 2006-03-29 |
| 1407822067 | Michael James Lupi | Pain Medicine | 11705 San Jose Blvd Ste 110, Jacksonville, FL 32223 | 2006-02-24 |
| 1720609381 | Guardian Medical Care Pllc | Pain Medicine | 943 Cesery Blvd Ste G, Jacksonville, FL 32211-5655 | 2020-05-05 |
| 1508355181 | Integrated Pain Services Inc | Pain Medicine | 4063 Salisbury Rd, Jacksonville, FL 32216-8030 | 2018-05-09 |
| 1154563591 | Courtney Melton Auman | Pain Medicine | 57 Office Park Dr, Jacksonville, NC 28546-7327 | 2009-03-31 |
| 1134282296 | Marla D Golden Do Pa | Pain Medicine | 6817 Southpoint Pkwy, Suite 1404, Jacksonville, FL 32216-6282 | 2006-12-19 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32224 |
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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.