| Jason Chauncey Spencer, PA-C | |
|
8761 Perimeter Park Blvd Ste 106, Jacksonville, FL 32216-6397 | |
| (904) 621-6628 | |
| (904) 346-0113 |
| Full Name | Jason Chauncey Spencer |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 21 Years |
| Location | 8761 Perimeter Park Blvd Ste 106, Jacksonville, Florida |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700995354 | NPI | - | NPPES |
| 100002298F | Medicaid | GA | |
| 100002298D | Medicaid | GA | |
| 10059208 | Other | GA | AMERIGROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 003768 (Georgia) | Secondary |
| 363A00000X | Physician Assistant | PA9103004 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Jasper Memorial Hospital | Monticello, GA | Hospital |
| Taylor Regional Hospital | Hawkinsville, GA | Hospital |
| Emory Houston Hospital Warner Robins | Warner robins, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southland Hawkinsville Emergency Medical Services, Llc | 2769600642 | 13 |
| Jasper Health Services Inc. | 7214901230 | 8 |
| Entity Name | Inphynet Primary Care Physicians Southeast PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770521460 PECOS PAC ID: 3779497045 Enrollment ID: O20031119000600 |
| Entity Name | Georgia Em-i Medical Services PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851569560 PECOS PAC ID: 0446157218 Enrollment ID: O20031218000621 |
| Entity Name | Jasper Health Services Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225031750 PECOS PAC ID: 7214901230 Enrollment ID: O20040824001236 |
| Entity Name | Acs Primary Care Physicians - Southeast PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861430555 PECOS PAC ID: 5193620714 Enrollment ID: O20040901000766 |
| Entity Name | Emergency Coverage LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427005008 PECOS PAC ID: 3072412592 Enrollment ID: O20050411000056 |
| Entity Name | Hospital Physician Services - Southeast Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760410385 PECOS PAC ID: 5597774554 Enrollment ID: O20060419000545 |
| Entity Name | Southland Emergency Medical Services Consolidated, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033464391 PECOS PAC ID: 4183871320 Enrollment ID: O20120823000503 |
| Entity Name | Houston County Emergency Group, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013338193 PECOS PAC ID: 2264663756 Enrollment ID: O20140326001461 |
| Entity Name | Southland Hawkinsville Emergency Medical Services, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1891100962 PECOS PAC ID: 2769600642 Enrollment ID: O20140908000486 |
| Entity Name | Southland Taylor Hospitalist Group, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093120909 PECOS PAC ID: 6800015959 Enrollment ID: O20140922002775 |
| Entity Name | Amelia Medical Services LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982910048 PECOS PAC ID: 1052530029 Enrollment ID: O20140924001378 |
| Entity Name | Houston Hospitalist Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962040147 PECOS PAC ID: 2769813906 Enrollment ID: O20200504000786 |
| Entity Name | Southland Behavioral Health Services LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619505765 PECOS PAC ID: 8224469085 Enrollment ID: O20200511002208 |
| Entity Name | Small Hospital Innovations LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184040560 PECOS PAC ID: 0840415444 Enrollment ID: O20220404000661 |
| Mailing Address | Practice Location Address |
|---|---|
| Jason Chauncey Spencer, PA-C 28 Yachtsmen Court, Woodbine, GA 31569 Ph: (912) 541-0243 | Jason Chauncey Spencer, PA-C 8761 Perimeter Park Blvd Ste 106, Jacksonville, FL 32216-6397 Ph: (904) 621-6628 |
Katherine L Walsh, PA-C/MPH Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 |
Teresa Louise Cowan, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1200 Riverplace Blvd, Suite 620, Jacksonville, FL 32207 Phone: 904-396-6620 Fax: 904-396-6528 |
Mrs. Melina Volner Sommese, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2594 Fax: 904-953-6225 |
Jessica Defazio, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 836 Prudential Dr Ste 1400, Jacksonville, FL 32207 Phone: 904-388-6518 Fax: 904-384-1005 |
Hangyu Shen Watson, M.D. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 |
Kayla Marie Demus Wilmot, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1215 Dunn Ave Ste 1, Jacksonville, FL 32218 Phone: 904-745-3618 |
Ryan David Asencios, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000 |