| Lyerly Baptist Inc | |
|
1650 Prudential Dr Ste 200, Jacksonville, FL 32207-8149 | |
| (904) 388-6518 | |
| (904) 384-1005 |
| Full Name | Lyerly Baptist Inc |
|---|---|
| Type | Facility |
| Speciality | Neurological Surgery |
| Location | 1650 Prudential Dr Ste 200, Jacksonville, Florida |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851347801 | NPI | - | NPPES |
| 274381700 | Medicaid | FL |
| Provider Name | Paulo Monteiro |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1184670135 PECOS PAC ID: 4284660465 Enrollment ID: I20050714000365 |
| Provider Name | Ashutosh A Pradhan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1982648432 PECOS PAC ID: 7719980861 Enrollment ID: I20060810000479 |
| Provider Name | Bradley A Wallace |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1134160161 PECOS PAC ID: 9436155009 Enrollment ID: I20061005000183 |
| Provider Name | Eric Sauvageau |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1346252814 PECOS PAC ID: 7214939735 Enrollment ID: I20070212000505 |
| Provider Name | Ricardo A Hanel |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1356394936 PECOS PAC ID: 0941251128 Enrollment ID: I20071018000318 |
| Provider Name | Shannon F Terrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891979456 PECOS PAC ID: 0345324174 Enrollment ID: I20080303000567 |
| Provider Name | Danielle Ramsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538319025 PECOS PAC ID: 6406917962 Enrollment ID: I20081203000321 |
| Provider Name | Donald Ellsworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528238540 PECOS PAC ID: 6002981792 Enrollment ID: I20081219000203 |
| Provider Name | Vanessa Z Riegert-johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720030950 PECOS PAC ID: 6002865250 Enrollment ID: I20090203000091 |
| Provider Name | Merlie M Sapin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184862153 PECOS PAC ID: 6608924584 Enrollment ID: I20090504000059 |
| Provider Name | Kristie D Sauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114160975 PECOS PAC ID: 7315090693 Enrollment ID: I20090804000511 |
| Provider Name | Belinda Monnig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871818591 PECOS PAC ID: 7012032592 Enrollment ID: I20100921000966 |
| Provider Name | Diane C. Mclaughlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548697261 PECOS PAC ID: 9234364639 Enrollment ID: I20131018001876 |
| Provider Name | Amogelang Marylin Keakopa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134557333 PECOS PAC ID: 8527293497 Enrollment ID: I20131030001490 |
| Provider Name | Casey Bonaquist |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689836918 PECOS PAC ID: 9032356639 Enrollment ID: I20140210001656 |
| Provider Name | Kristin L Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790118206 PECOS PAC ID: 4082846928 Enrollment ID: I20140408002158 |
| Provider Name | Jennifer L Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760803431 PECOS PAC ID: 0244462190 Enrollment ID: I20140408002202 |
| Provider Name | Marjorie M Donnelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639596125 PECOS PAC ID: 0042442519 Enrollment ID: I20140416000028 |
| Provider Name | Daniel Cortelazzi Ferreira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770909327 PECOS PAC ID: 9739311002 Enrollment ID: I20140421001065 |
| Provider Name | Michael A Yorio |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1902810732 PECOS PAC ID: 9739077454 Enrollment ID: I20140826000916 |
| Provider Name | Kristin S Davies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407258114 PECOS PAC ID: 4587986583 Enrollment ID: I20141203002214 |
| Provider Name | Jan Michael Trinidad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225433758 PECOS PAC ID: 3577888239 Enrollment ID: I20150220002414 |
| Provider Name | Emily Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861887770 PECOS PAC ID: 3870813892 Enrollment ID: I20150514002108 |
| Provider Name | Adam Jordan Polifka |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1427251230 PECOS PAC ID: 5991017394 Enrollment ID: I20150626000813 |
| Provider Name | Heather M Bean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104200450 PECOS PAC ID: 2466768866 Enrollment ID: I20150831002270 |
| Provider Name | Neeraj S Naval |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1285730374 PECOS PAC ID: 2860491750 Enrollment ID: I20150914001604 |
| Provider Name | Anthony J Ossorio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861878241 PECOS PAC ID: 8628388576 Enrollment ID: I20151105002144 |
| Provider Name | Annamarie M Hoffecker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710356977 PECOS PAC ID: 7810297983 Enrollment ID: I20151120001359 |
| Provider Name | Mohamad Chmayssani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780847244 PECOS PAC ID: 7517115058 Enrollment ID: I20151221001648 |
| Provider Name | Sally R Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891173688 PECOS PAC ID: 1951607167 Enrollment ID: I20160315001525 |
| Provider Name | Amin Nima Aghaebrahim |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1558504423 PECOS PAC ID: 1557594355 Enrollment ID: I20160613001821 |
| Provider Name | Sarah S Decker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538529235 PECOS PAC ID: 8729379565 Enrollment ID: I20160624001134 |
| Provider Name | Andrew B Shaw |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1437487709 PECOS PAC ID: 7214176056 Enrollment ID: I20160831001371 |
| Provider Name | Yogesh Moradiya |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306077177 PECOS PAC ID: 1951555127 Enrollment ID: I20160921000725 |
| Provider Name | Sara Michele Woolsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285085035 PECOS PAC ID: 2062797905 Enrollment ID: I20170316000901 |
| Provider Name | Kyle M Starck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467976399 PECOS PAC ID: 3678830114 Enrollment ID: I20171208000207 |
| Provider Name | Jharna Nitin Shah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083935670 PECOS PAC ID: 6103040217 Enrollment ID: I20190826003567 |
| Provider Name | Corynn Garrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609419811 PECOS PAC ID: 9032545280 Enrollment ID: I20200206000256 |
| Provider Name | Annalise M Deboef |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053926501 PECOS PAC ID: 4082034251 Enrollment ID: I20201009001579 |
| Provider Name | Anthony Abrigo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578144523 PECOS PAC ID: 4284894171 Enrollment ID: I20210527001654 |
| Provider Name | Lyndsey Jean Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942773106 PECOS PAC ID: 6406256692 Enrollment ID: I20210609001957 |
| Provider Name | Harrison Scott Mahon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477943579 PECOS PAC ID: 9032426515 Enrollment ID: I20210727002760 |
| Provider Name | Marcia M Camero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639598352 PECOS PAC ID: 0042506586 Enrollment ID: I20211029002246 |
| Provider Name | Kimberly Cribbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679980353 PECOS PAC ID: 6002135688 Enrollment ID: I20220131001368 |
| Provider Name | Kimberlee Nicole Leek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013325943 PECOS PAC ID: 1153618863 Enrollment ID: I20220201002737 |
| Provider Name | Daniel S Ikeda |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1164751947 PECOS PAC ID: 5395984181 Enrollment ID: I20220208001263 |
| Provider Name | Joe P Bhagratie |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1346801453 PECOS PAC ID: 3678900644 Enrollment ID: I20220920001105 |
| Provider Name | Ryan Alexander Pal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538854690 PECOS PAC ID: 9335505536 Enrollment ID: I20230512002201 |
| Provider Name | Joseph Spinelli |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1851653406 PECOS PAC ID: 9830426949 Enrollment ID: I20230518001140 |
| Provider Name | Melissa Ann Wasilenko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427740224 PECOS PAC ID: 8729446067 Enrollment ID: I20230620001251 |
| Provider Name | John C Muse |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1881058741 PECOS PAC ID: 2365737962 Enrollment ID: I20230621000616 |
| Provider Name | Sasha Vaziri |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1023495017 PECOS PAC ID: 6800101924 Enrollment ID: I20230622003573 |
| Provider Name | Kara J Shaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457827503 PECOS PAC ID: 6709123953 Enrollment ID: I20231017001123 |
| Provider Name | Victor Hugo Da Costa Benalia |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1528796869 PECOS PAC ID: 7719428754 Enrollment ID: I20240918002054 |
| Provider Name | Savannah Nicole Burgess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285325274 PECOS PAC ID: 6103351911 Enrollment ID: I20241203000126 |
| Provider Name | Kurt A Madzunovic |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629495981 PECOS PAC ID: 6800184730 Enrollment ID: I20241217001795 |
| Provider Name | Faith V Keener |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073339545 PECOS PAC ID: 6204364516 Enrollment ID: I20250115000703 |
| Mailing Address | Practice Location Address |
|---|---|
| Lyerly Baptist Inc Po Box 746647, Atlanta, GA 30374-6647 Ph: (904) 202-2092 | Lyerly Baptist Inc 1650 Prudential Dr Ste 200, Jacksonville, FL 32207-8149 Ph: (904) 388-6518 |