Kevin Holthaus (NPI# 1003893215, PAC ID# 2860425147) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1003893215 |
| PAC ID by PECOS | 2860425147 |
| Professional Enrollment ID | I20050917000269 |
| Full Name | Kevin Holthaus |
| Organization Legal Name | NORTH FLORIDA MEDICAL CLINIC INC |
| Address |
1361 13th Ave S Suite 150 Jacksonville Beach FL 32250-3235 |
| Phone Number | 9042427177 |
| Gender | M |
| Credential | MD |
| Medical School | MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE |
| Graduation Year | 1982 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 7315970688 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100117 | BAPTIST MEDICAL CENTER BEACHES |
| Address | Phone | Organization |
|---|---|---|
| 1361 13th Ave S, Suite 150, Jacksonville Beach, FL 32250-3235 | 9042427177 | NORTH FLORIDA MEDICAL CLINIC INC |
| Organization Legal Name | NORTH FLORIDA MEDICAL CLINIC INC |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David Johnson | Family Medicine | North Florida Medical Clinic Inc | 1361 13th Ave S, Suite 150, Jacksonville Beach, FL 32250-3235 |
| Anthony Vetere | Internal Medicine | North Florida Medical Clinic Inc | 1361 13th Ave S, Suite 150, Jacksonville Beach, FL 32250-3235 |
| Street Address |
1361 13TH AVE S SUITE 150 |
| City | JACKSONVILLE BEACH |
| State | FL |
| Zip | 32250-3235 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Richard J Boehme Jr. | Neurology | 1361 13th Ave S, Suite 170a, Jacksonville Beach, FL 32250-3235 | |
| Kathryn Fipp Bing | Obstetrics/gynecology | Womens Care Florida LLC | 1361 13th Ave S, Suite 190, Jacksonville Beach, FL 32250-3235 |
| David Johnson | Family Medicine | North Florida Medical Clinic Inc | 1361 13th Ave S, Suite 150, Jacksonville Beach, FL 32250-3235 |
| Christine S Ng | Dermatology | 1361 13th Ave S, Suite 180, Jacksonville Beach, FL 32250-3235 | |
| Sayra C. Sievert | Obstetrics/gynecology | Womens Care Florida LLC | 1361 13th Ave S, Suite 190, Jacksonville Beach, FL 32250-3235 |
| Calvin Cameron Greene | Obstetrics/gynecology | Womens Care Florida LLC | 1361 13th Ave S, Suite 190, Jacksonville Beach, FL 32250-3235 |
| Bradley A Herbst | Podiatry | Podiatry Associates of Florida Inc | 1361 13th Ave S, Suite 120, Jacksonville Beach, FL 32250-3260 |
| Anthony Vetere | Internal Medicine | North Florida Medical Clinic Inc | 1361 13th Ave S, Suite 150, Jacksonville Beach, FL 32250-3235 |
| Hector C Pagan | Pain Management | 1361 13th Ave S, Suite 210, Jacksonville Beach, FL 32250-3236 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary E Southwick-jones | Clinical Social Worker | 4300 Marsh Landing Blvd, Suite 204, Jacksonville Beach, FL 32250-1420 | |
| Candice P Ster | Clinical Social Worker | 4300 Marsh Landing Blvd, Suite 204, Jacksonville, FL 32250-1420 | |
| Selina W Beenen | Clinical Social Worker | 4300 Marsh Landing Blvd, Suite 204, Jacksonville Beach, FL 32250-1420 | |
| Kelly Gardner Rich | Family Medicine | Baptist Primary Care Inc | 14011 Beach Blvd, Suite 230, Jacksonville, FL 32250-1507 |
| Payvand Tiurchy | Family Medicine | Baptist Primary Care Inc | 14011 Beach Blvd, Suite 230, Jacksonville, FL 32250-1507 |
| Susan N Young | Psychologist, Clinical | 14286 Beach Blvd, Suite 22, Jacksonville, FL 32250-1569 | |
| Lauren Kay Smedley | Chiropractic | Cooper Chiropractic and Family Wellness Inc | 14333 Beach Blvd, Suite 2, Jacksonville, FL 32250-1587 |
| Lisa A Karr | Nurse Practitioner | Physicians Group Services Pa | 14011 Beach Blvd, Suite 120, Jacksonville, FL 32250-1695 |
| Jaclyn Taylor | Nurse Practitioner | Physicians Group Services Pa | 14011 Beach Blvd, Suite 120, Jacksonville, FL 32250-1695 |
| Howard J Green | Family Medicine | Family Care Partners of Northeast Florida LLC | 14444 Beach Blvd, Suite 27, Jacksonville, FL 32250-2079 |
| Find all physicians in zip 32250 | |||
| City | JACKSONVILLE BEACH |
| Zip Code | 32250 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | JACKSONVILLE BEACH + INTERNAL MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.