Seven Bridges Pain Specialists LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

SEVEN BRIDGES PAIN SPECIALISTS LLC

Practice address

2023 Myra St
Jacksonville, FL 32204-3714

Phone

(904) 503-5464

Fax

(904) 575-4399

NPI assigned

Jan 20, 2023

Organization subpart

No

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

Authorized official

Name

Renee Gallo, MDNPI 1043524119

Title

Owner

Phone

(904) 503-5464

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Renee Gallo, M.D.

  • Pain Medicine Physician
  • Jacksonville, FL
  • NPI 1043524119
  Medicare reassignment Care Compare group NPD Authorized official
• Andrew David Green, ARNP

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1396007993
  Medicare reassignment Care Compare group NPD
• David Leduke

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1962298745
  Medicare reassignment Care Compare group NPD
• Jeffrey Michael Green, PA-C

  • Physician Assistant
  • Jacksonville, FL
  • NPI 1912979584
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694390400000",
    "number": "1225743404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 MYRA ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043714",
            "telephone_number": "904-503-5464",
            "fax_number": "904-575-4399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 MYRA ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043714",
            "telephone_number": "904-503-5464",
            "fax_number": "904-575-4399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4745 Sutton Park Ct Ste 501",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322240251",
            "country_code": "US",
            "telephone_number": "904-503-5464",
            "fax_number": "904-575-4399",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SEVEN BRIDGES PAIN SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A",
        "authorized_official_last_name": "GALLO",
        "authorized_official_first_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-503-5464",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seton Pharmacy Inc (Seton Pharmacy Northside)
• Mellissa Settles, ARNP
• Barry Philip Setzer, DDS
• Divya Seval, MD
• Seven Bridges Chiropractic
• Seven Bridges Pain Specialists LLC
• Seven Bridges Therapies LLC
• Seven Oaks Therapy LLC
• Dawson Lane Severin
• Tamara Nicole Sewell

• Interventional Pain Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Interventional Pain Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.