Stephen B. Gill, M.D.,P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0037009 Issued in FL

Legal business name

STEPHEN B. GILL, M.D.,P.A.

Practice address

3189 US Highway 17 S
Green Cove Springs, FL 32043-9371

Phone

(904) 284-2828

Fax

(904) 284-2810

NPI assigned

Jun 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Stephen Boyd Gill, M.D.

Title

President

Phone

(904) 284-2828

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922035500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3189 HIGHWAY 17 S",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320439371",
            "telephone_number": "904-284-2828",
            "fax_number": "904-284-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3189 US HIGHWAY 17 S",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320439371",
            "telephone_number": "904-284-2828",
            "fax_number": "904-284-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN B. GILL, M.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-284-2828",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0037009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "208457",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "15612",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Smith, FNP-BC
• Lawrence Matthew Smith, PHARMD
• Qiana Smith
• Hannah Souksavong, PT, DPT
• Thomas E Stakem, D.D.S.,M.D.
• Hannah Mae Lynn Steward, RBT
• Kristina Stewart, M.A.
• April Rae Stone, D.M.D.
• Edmund Deforest Sugzdinis I, HEARING INSTRUMENT S
• Staci Lorenzo Suits

• Family Medicine Physician in Green Cove Springs, FL
• Providers in Green Cove Springs, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.