Regina M George, NP
Individual provider Active NPI Nurse Practitioner · Jacksonville, FL
NPI 1477079036 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1477079036
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- ARNP1838582 (FL)
- Practice address
- 2627 Riverside Ave
Jacksonville, FL 32204-4712 - Phone
- (904) 308-7372
- Fax
- (904) 308-2908
- NPI assigned
- Aug 16, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171014000260 | FL | Practitioner - Nurse Practitioner | 0345515516 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP1838582 | FL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vitalmd Group Holding LLC | Current |
Accepting new patients | |
| HN Ucc LLC | Current |
Accepting new patients | |
| Primecare Acquisition Family Practice Inc | Current |
Accepting new patients | |
| New Smyrna Beach Gynecology & Obstetrics PA | Nurse Practitioner | Current |
Accepting new patients |
| Primecare at Twin Lakes LLC | Current |
Accepting new patients | |
| St Vincents Medical Center Inc | Current |
Accepting new patients | |
| St Vincents Medical Center Inc | Current |
Accepting new patients | |
| Port Orange Gynecology LLC | Current | Accepting new patients |
Locations
1890 Lpga Blvd
Ste 130
Daytona Beach, FL 32117
Phone (386) 274-2212
3048 S Atlantic Ave
Daytona Beach Shores, FL 32118
Phone (386) 457-8758
2090 Saxon Blvd
Deltona, FL 32725
Phone (386) 845-5452
2627 Riverside Ave
Jacksonville, FL 32204
Phone (904) 308-7372
3225 Aviation Ave
Ste 700
Miami, FL 33133
Phone (305) 273-4641
603 S Orange St
New Smyrna Beach, FL 32168
Phone (386) 423-0333
775 W Granada Blvd
Ste 102
Ormond Beach, FL 32174
Phone (386) 425-4480
5440 S Williamson Blvd
Port Orange, FL 32128
Phone (386) 845-5451
Interoperability endpoints
- https://api.platform.athenahealth.com/7069/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | ARNP1838582 | FL | Yes |
Addresses
Primary practice location
2627 Riverside Ave
Jacksonville, FL 32204-4712
Mailing address
2627 Riverside Ave
Jacksonville, FL 32204-4712
Phone (904) 308-7372
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ARNP1838582 | Other | FL | LICENSE |
Other providers in Jacksonville, FL
- Kristin George
- Martha Rosanne McNeill George
- Matthew Stephen George
- Morgan George
- Naketa George
- Sarah Margaret George
- Marian Georgi
- Marianna Ioanni Georgiadou
- Anton S Georgiev
- Brooke Gabrielle Gephart
All providers in Jacksonville, FL · Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.