Individual provider Active NPI

Gerardo Augusto Montanez Galvis, ARNP

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1093061723
Registry record updated Sep 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9285572 Issued in FL
Practice address
1215 Dunn Ave
Suite 1
Jacksonville, FL 32218-6330
Phone
(904) 696-7474
Fax
(904) 696-7476
NPI assigned
Jul 31, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9285572 FL Primary

Addresses

Primary practice location

1215 Dunn Ave
Suite 1
Jacksonville, FL 32218-6330

Mailing address

6520 Fort Caroline Rd
Jacksonville, FL 32277-2044
Phone (904) 745-3618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130301000408 FL Practitioner - Nurse Practitioner 1355596024

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6520 Fort Caroline Rd
Jacksonville, FL 32277-2044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Avecina Medical PA CurrentSince Oct 1, 2016 Accepting new patients
Avecina Medical, PA CurrentSince Oct 1, 2016 Accepting new patients
Physicians Medical Center, Inc. Past Accepting new patients
Physicians Medical Centers-Jax Inc PastSince Sep 25, 2012 Accepting new patients
Family Care Partners Urgent Care, LLC PastSince Sep 2, 2014 Accepting new patients

Locations

4160 Southside Blvd
Ste 10
Jacksonville, FL 32216
Phone (904) 900-1717

4815 Sweetgrass Pl
Unit 201
Jacksonville, FL 32224
Phone (904) 367-3372

1633 Race Track Rd
Ste 1
Jacksonville, FL 32259
Phone (904) 230-6988

2020 Kingsley Ave
Ste A
Orange Park, FL 32073
Phone (904) 458-1308

1633 Race Track Rd
Ste 101
St Johns, FL 32259
Phone (904) 230-6988

Interoperability endpoints

  • Direct secure messaging: gerardo.montanez.1@10406.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1093061723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 FORT CAROLINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322772044",
            "telephone_number": "904-745-3618",
            "fax_number": "904-722-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 DUNN AVE",
            "address_2": "SUITE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186330",
            "telephone_number": "904-696-7474",
            "fax_number": "904-696-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTANEZ GALVIS",
        "first_name": "GERARDO",
        "middle_name": "AUGUSTO",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-31",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9285572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.