Jacksonville Spine Center PA
NPI 1881643757ActiveOrganization· Anesthesiology, Pain Medicine· Jacksonville, FL
Anesthesiology, Pain Medicine in Jacksonville, Florida, registered in NPPES in May 2006. The authorized official on file is Alicia M. Groth, Credentialing Specialist. Enrolled in Medicare as dme supplier - physician - interventional pain management and part b supplier - clinic/group practice.
Overview
| NPI | 1881643757 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 9, 2006 |
| Last updated in NPPES | May 9, 2023 |
| Certified by provider | May 9, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Anesthesiology, Pain Medicine Primary | 207LP2900X | — | — |
| Pain Medicine, Interventional Pain Medicine | 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); Part B Supplier - Clinic/Group Practice (FL) |
|---|
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