NICHOLAS D A PETERKIN


Address: 9090 Regency Square Blvd, Jacksonville, FL 32211-8119
Phone: 9047245576

NICHOLAS D A PETERKIN (NPI# 1912211905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912211905
Entity Type Individual
Full Name NICHOLAS D A PETERKIN
Credential M.D.
Practice Address 9090 Regency Square Blvd
Jacksonville
FL 32211-8119
Mailing Address Po Box 45443
Salt Lake City
UT 84145-0443
Practice Telephone 9047245576
Practice Fax Number 9043764107
Mailing Telephone 9042021032
Mailing Fax Number 9043764107
Enumeration Date 2010-08-02
Last Update Date 2018-12-18
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine ME114121 FL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
FL RAILROAD MEDICARE P01346898 01

Office Location

Street Address 9090 REGENCY SQUARE BLVD
City JACKSONVILLE
State FL
Zip Code 32211-8119

Providers in the same location

NPI Name Taxonomy Address Enumeration
1629054978 Jeffry D Altomare Pediatrics 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 2005-12-19
1649823477 Kristina Ashley Pound Butler Nurse Practitioner 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 2019-07-21
1447504527 Belynda F Mccurry Physician Assistant 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 2012-10-29
1477832715 Kristen Nicole Galloway Psychologist 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 2011-08-04
1073830725 Muhammad A Ghazi Family Medicine 9090 Regency Square Blvd, Jacksonville, FL 32211 2010-04-21
1891976734 Baptist Primary Care Inc Internal Medicine 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 2007-11-20
1720113533 Thomas Mark Lundy Physician Assistant 9090 Regency Square Blvd, Credentialing Department, Jacksonville, FL 32211-8119 2007-02-22
1871523894 Farah Malik Family Medicine 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 2006-07-04
1255309332 Manuel Portalatin Family Medicine 9090 Regency Square Blvd, Credentialing Department, Jacksonville, FL 32211-8119 2006-03-14
1104894393 James A Waler Pediatrics 9090 Regency Square Blvd, Jacksonville, FL 32211-8119 2006-03-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1457951758 Ebs Childrens Therapy - Fl LLC Behavioral Analyst 5491 Dolphin Point Blvd, Jacksonville, FL 32211 2020-10-27
1700412822 Marie Vernal Social Worker 6051 Arlington Expressway Suite 169, Jacksonville, FL 32211 2020-03-20
1992336895 Dolphin Pointe Health Care, LLC Skilled Nursing Facility 5355 Dolphin Point Rd., Jacksonville, FL 32211 2020-01-29
1366089641 Prophetic Healing Deliverance Ministry of Mysteries, Inc Counselor 8550-2 Lone Star Road, Jacksonville, FL 32211 2019-12-05
1922656370 Timothy Richard Barron Behavior Technician 5633 Clifton Ln, Jacksonville, FL 32211 2019-08-29
1023583325 Linnzi Marks Behavioral Analyst 6014 Wateredge Ln, Jacksonville, FL 32211 2018-10-12
1780160192 Ganesh Healthcare of Jax LLC Alzheimer Center (Dementia Center) 644 Cesery Blvd Ste 150, Jacksonville, FL 32211 2018-07-18
1902397276 Chandra Harris Washington In Home Supportive Care 2712 Gaillardia Rd, Jacksonville, FL 32211 2018-05-22
1043730062 Monica R Iskander Dentist 465 University Blvd N, Jacksonville, FL 32211 2017-06-21
1205366895 Lilibeth Bundang Adona Custodial Care Facility 1818 Townsend Blvd, Jacksonville, FL 32211 2017-06-15
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1528676186 Sarah Colleen Tapscott Family Medicine 1908 Mill Creek Rd, Jacksonville, FL 32211-5052 2020-07-20
1790303170 Samantha L Scott Family Medicine 516 Pierce Ln, Jacksonville, TX 75766-4546 2020-07-11
1689298689 Meridian Spine and Joint, Inc Family Medicine 9770 Old Baymeadows Rd Ste 139, Jacksonville, FL 32256-7986 2020-06-04
1154942563 Families First Medical Group Family Medicine 12086 Fort Caroline Rd Ste 103, Jacksonville, FL 32225-2688 2020-04-27
1598396392 Pareto Population Health Management Practice Pllc Family Medicine 1697 Kings Rd Ste 1, Jacksonville, FL 32209-6169 2020-01-30
1942862206 Cindy S Wright Do Pllc Family Medicine 12627 San Jose Blvd Ste 902, Jacksonville, FL 32223-8645 2019-07-07
1942868377 Pain Spine & Wellness LLC Family Medicine 9770 Old Baymeadows Rd Ste 141, Jacksonville, FL 32256-7986 2019-05-31
1669035705 Kathy Jo Daniels Family Medicine 10457 Wellington Springs Way, Jacksonville, FL 32221-1175 2019-04-15
1821579103 Tiffany N Major Family Medicine 5194 Johnson Creek Dr, Jacksonville, FL 32218-9308 2018-08-24
1568987360 Main Street Health LLC Family Medicine 2 Shircliff Way Ste 620, Jacksonville, FL 32204-4762 2017-08-14
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Competitor

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City JACKSONVILLE
Zip Code 32211

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Dataset Information

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.

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