Bonni G. Titcomb, A.R.N.P.

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

ARNP 624442 Issued in FL

Practice address

1577 Roberts Dr
Siote 323
Jacksonville Beach, FL 32250-3264

Phone

(904) 241-9775

Fax

(904) 249-3638

NPI assigned

Jun 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1366484842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16568",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322456568",
            "telephone_number": "904-472-2300",
            "fax_number": "904-472-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1577 ROBERTS DR",
            "address_2": "SIOTE 323",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503264",
            "telephone_number": "904-241-9775",
            "fax_number": "904-249-3638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITCOMB",
        "first_name": "BONNI",
        "middle_name": "G.",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "FL",
            "license": "ARNP 624442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308691700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tides Edge Recovery Services, LLC
• Tides Edge Recovery Services, LLC
• Ginger Tidwell, PT, DPT, ACSM-EP
• Rachell Lynn Tillman, FL MA 76980
• Timothy L Schneider, MD PA
• Payvand Tiurchy, M.D.
• David C Tolbert, MA, LMHC
• Jeffrey Thomas Tomamichel, D.D.S.
• Mark Christopher Tomaski, M.D.
• Laura Tomino, PT, DPT

• Obstetrics & Gynecology Nurse Practitioner in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Obstetrics & Gynecology Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; 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.