Yergin Pulmonary Clinic PA

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

ME21067 Issued in FL

Legal business name

YERGIN PULMONARY CLINIC PA

Practice address

3627 University Blvd S
Suite 300
Jacksonville, FL 32216-4230

Phone

(904) 396-0300

Fax

(904) 396-3039

NPI assigned

Aug 20, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Bruce M Yergin, M.D.

Title

President

Phone

(904) 396-0300

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282521600000",
    "number": "1144536749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S",
            "address_2": "SUITE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164230",
            "telephone_number": "904-396-0300",
            "fax_number": "904-396-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S",
            "address_2": "SUITE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164230",
            "telephone_number": "904-396-0300",
            "fax_number": "904-396-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YERGIN PULMONARY CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-20",
        "last_updated": "2010-08-23",
        "status": "A",
        "authorized_official_last_name": "YERGIN",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-396-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME21067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "78027",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "215889",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0418040400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NPI",
            "identifier": "1619962230",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5362087",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "406293079",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel J. Ybarra, PH.D.
• Amy Lynn Yearwood, PTA
• Alexander J Yeats Jr., MD
• C Yelvington, PT
• Catherine A Yelvington, PT
• Bruce Mitchell Yergin, M.D.
• Lauren Brooke Yerkes, PSY.D.
• John Robert Yerxa, MD
• Yes to Life Homemaker & Companion Services. LLC
• Jeremy Yesudhas, M.D.

• Pulmonary Disease Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pulmonary Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.