Emergency Medical Specialists of Jacksonville
Organization Active NPI Emergency Medicine Physician · Jacksonville, FL
NPI 1295738367 · NPPES record last updated Feb 19, 2013
Key facts
- NPI
- 1295738367
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- EMERGENCY MEDICAL SPECIALISTS OF JACKSONVILLE
- Practice address
- 1 Shircliff Way
Jacksonville, FL 32204-4778 - Phone
- (904) 308-7300
- Fax
- (419) 866-5453
- NPI assigned
- May 23, 2005
- Organization subpart
- No
Authorized official
- Name
- Dr. Paul Lucey, MD
- Title
- Partner
- Phone
- (904) 308-7300
Practitioners 148
-
Paul D Lucey, MD
-
Elizabeth G. Bagan, ARNP, NP-C, ENP-C
-
Bradley Berger, MD
-
Joe P Bhagratie, DO
-
Wylene N Bhanji, DO
-
Laurie Susan Bryant, D.O.
-
Monica J Cox, ARNP
-
Kelly Daniels, ARNP
-
Carolyn L Deloache, MSN ARNP
-
Lacey Leigh Dietrich, ARNP
-
Teresa A. Edison, ARNP
-
Arnold Feliciano, ARNP
-
Geoffrey Finn, APRN
-
Tiffany Gaither, ACNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040313000203 | FL | Part B Supplier - Clinic/Group Practice | 2668361080 |
Receives reassigned benefits from 115 practitioners Practice locations: Jacksonville, FL; St Johns, FL; Middleburg, FL |
National Provider Directory
Locations
1580 Branan Field Rd
Middleburg, FL 32068
Phone (904) 214-9102
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
1 Shircliff Way
Jacksonville, FL 32204-4778
Mailing address
PO Box 863026
Orlando, FL 32886-3026
Phone (800) 288-8325
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 99356 | Other | FL | BCBS GROUP NUM |
| 038371600 | Medicaid | FL |
Other providers in Jacksonville, FL
- Emed Urgent and Primary Care Inc
- Emed Urgent and Primary Care PA
- Emed Urgent Care Center PA
- Emed Urgent Care LLC
- Emerald Intraoperative Neuromonitoring , PLLC
- Emergency Physicians Inc
- Emergency Physicians Inc
- Emergency Physicians Inc
- Emergency Physicians Inc
- Emergency Physicians Inc
All providers in Jacksonville, FL · Emergency Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.