JACKSONVILLE SPINE CENTER PA (NPI# 1891309340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891309340 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE SPINE CENTER PA |
| Practice Address |
6500 Crill Ave Palatka FL 32177-9230 |
| Mailing Address |
10475 Centurion Pkwy N Ste 201 Jacksonville FL 32256-5004 |
| Practice Telephone | 9042233321 |
| Practice Fax Number | 9042232169 |
| Mailing Telephone | 9042233321 |
| Mailing Fax Number | 9042232169 |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |
| Authorized Official Name | ALICIA GROTH (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 9042233321 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912560798 | Jacksonville Spine Center Pa | Pain Medicine | 2349 Village Square Pkwy Ste 107, Fleming Island, FL 32003-4319 | 2019-04-17 |
| 1194248229 | Jacksonville Spine Center Pa | Pain Medicine | 1100 Plantation Island Dr S Ste 220, St Augustine, FL 32080-5174 | 2017-07-20 |
| 1326659236 | Jacksonville Spine Center Pa | Pain Medicine | 1699 S 14th St Ste 16, Fernandina Beach, FL 32034-1965 | 2020-08-13 |
| 1760976260 | Jacksonville Spine Center Pa | Pain Medicine | 15255 Max Leggett Pkwy Ste 5500, Jacksonville, FL 32218-7273 | 2018-06-18 |
| 1881643757 | Jacksonville Spine Center Pa | Pain Medicine | 10475 Centurion Pkwy N Ste 201, Jacksonville, FL 32256-5004 | 2006-05-09 |
| Street Address |
6500 CRILL AVE |
| City | PALATKA |
| State | FL |
| Zip Code | 32177-9230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477519361 | Robert Pendrak | Family Medicine | 6500 Crill Ave, Palatka, FL 32177-9230 | 2006-04-21 |
| 1598395816 | Express Urgent Care, LLC | Clinic/Center | 6500 Crill Ave, Bldg 3 Ste 5, Palatka, FL 32177-9231 | 2020-01-26 |
| 1831748623 | Andrea Margaret Bytheway | Nurse Practitioner | 6500 Crill Ave, Palatka, FL 32177-9230 | 2019-09-05 |
| 1144732504 | Thomas Llewellyn Christopher | Nurse Practitioner | 6500 Crill Ave, Palatka, FL 32177-9230 | 2017-10-25 |
| 1134563679 | E. David Risch, M.d., P.a. | Orthopaedic Surgery | 6500 Crill Ave, E David Risch, Palatka, FL 32177-9230 | 2013-04-27 |
| 1174892830 | Medex Primary Care | Clinic/Center | 6500 Crill Ave, Bldg 3 Ste 1, Palatka, FL 32177-9230 | 2011-12-23 |
| 1376830521 | Courtesy Transport Services, LLC | Ambulance | 6500 Crill Ave, Palatka, FL 32177-9230 | 2011-07-07 |
| 1740504737 | Deanna Wilkinson | Massage Therapist | 6500 Crill Ave, Suite 3, Palatka, FL 32177-6807 | 2010-03-18 |
| 1346481629 | Med Ex | Preferred Provider Organization | 6500 Crill Ave, Palatka, FL 32177-6807 | 2009-03-16 |
| 1841463601 | Robert B Dehgan Md Pa | Neuromusculoskeletal Medicine, Sports Medicine | 6500 Crill Ave, Palatka, FL 32177-6807 | 2008-04-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174124176 | Charlie Douglas | Pharmacist | 1024 South State Road 19, Pharmacy, Palatka, FL 32177 | 2020-11-05 |
| 1275090359 | Carol M Kazounis | Dietitian, Registered | 2801 Kennedy Strett, Palatka, FL 32177 | 2019-02-26 |
| 1447744768 | Pulido Internal Medicine | Nurse Practitioner | 700 Zeagler Drive, Suite 1, Palatka, FL 32177 | 2018-06-20 |
| 1063922656 | Ronald Michael Wendt | Nurse Practitioner | 3703 Crill Ave, Palatka, FL 32177 | 2017-10-09 |
| 1043560212 | Leslie Ann Lewis | Massage Therapist | 325 Poinsetta Ave, Palatka, FL 32177 | 2012-09-14 |
| 1285984963 | Walgreens | Pharmacy | 719 South State Road 19, Palatka, FL 32177 | 2012-09-11 |
| 1841549235 | Audrey M Russell | Pharmacy Technician | 719 Hwy 19 South, Palatka, FL 32177 | 2012-08-31 |
| 1194023838 | Sherry D. Michael | Licensed Practical Nurse | 330 Kay Larkin Dr., Palatka, FL 32177 | 2011-03-04 |
| 1083846364 | Patricia Kowalchuk | Occupational Therapy Assistant | 6050 St.johns Ave., Suite A, Palatka, FL 32177 | 2009-08-20 |
| 1609015320 | Robin Calhoun | Occupational Therapist | 611 Zeagler Dr., Palatka, FL 32177 | 2009-02-19 |
| Find all providers in zip 32177 | ||||
| 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 |
|---|---|---|---|---|
| 1306452115 | Premier Pain and Wellness LLC | Pain Medicine | 12555 Sw 46th St, Miami, FL 33175-4725 | 2020-09-17 |
| 1861043929 | Spine Center of Fl LLC | Pain Medicine | 9400 Bonita Beach Rd Se Ste 101, Bonita Springs, FL 34135-4520 | 2019-09-20 |
| 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 |
| 1619442209 | Family Spine and Pain Care Institute LLC | Pain Medicine | 1525 Tamiami Trl S Ste 601, Venice, FL 34285-3568 | 2018-10-10 |
| 1215429717 | Pain Treatment Specialists | Pain Medicine | 2601 E Oakland Park Blvd Ste 200, Fort Lauderdale, FL 33306 | 2018-05-31 |
| 1164912754 | Superior Physician Group | Pain Medicine | 10730 N 56th St Ste 209, Temple Terrace, FL 33617 | 2018-05-18 |
| 1568977973 | Prc Associates, LLC | Pain Medicine | 1545 Hand Ave Ste Az, Ormond Beach, FL 32174-1139 | 2017-12-07 |
| 1710406228 | Sasha Saidi | Pain Medicine | 16810 South Highway 441, Suite 502, Summerfield, FL 34491 | 2017-09-15 |
| 1003341280 | Yvonne Derickson | Pain Medicine | 105 Whitehall Dr Ste 115-116, St Augustine, FL 32086-5269 | 2017-04-26 |
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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.