Jacksonville Spine Center PA
NPI 1760976260ActiveOrganization· Pain Medicine, Interventional Pain Medicine· Jacksonville, FL
Pain Medicine, Interventional Pain Medicine in Jacksonville, Florida, registered in NPPES in June 2018. The authorized official on file is Alicia Groth, Credentialing Specialist. Enrolled in Medicare as dme supplier - physician - interventional pain management.
Overview
| NPI | 1760976260 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 18, 2018 |
| Last updated in NPPES | Sep 26, 2022 |
| Certified by provider | Sep 20, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pain Medicine, Interventional Pain Medicine Primary | 208VP0014X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Interventional Pain Management (FL) |
|---|
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