Nicolas Charles Condrey, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9104578 Issued in FL

Practice address

1320 Roberts Dr Ste 101
Jacksonville Beach, FL 32250-3253

Phone

(904) 241-7147

Fax

(904) 376-3213

NPI assigned

May 15, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: ncondrey22599@baptisthealthsystemjacksonville.direct-ci.com

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1659548949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746652",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746652",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 ROBERTS DR STE 101",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503253",
            "telephone_number": "904-241-7147",
            "fax_number": "904-376-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDREY",
        "first_name": "NICOLAS",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-15",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104578",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012730800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Alan Coltman, MPT
• Meghan Carroll Coman, OTR/L
• Commonwealth Mediation Services, Inc.
• Commonwealth Mediation Services, Inc.
• Concierge Physio LLC
• Dana Conilogue, DPT
• Christina Anderson Conner, MD
• Cathleen Teresa Connolly, PH.D.
• Mikayla Emerald Cooper, RD
• Rebecca Cooper, MD

• Physician Assistant in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.