OrganizationActive
Jacksonville Spine Center PA
NPI 1891309340 · Pain Medicine Physician · Palatka, FL
Provider details
- NPI number
- 1891309340
- Entity type
- Organization
- Primary specialty
- Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Alicia Groth, Credentialing Specialist(904) 223-3321
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
205 Zeagler Dr Ste 401
Palatka, FL 32177-3887
Phone: (904) 223-3321
Fax: (904) 223-2169
Street-level locationGet directions
Mailing address
5191 First Coast Tech Pkwy
Jacksonville, FL 32224-5004
Other names (DBA / former)
- Doing business as
- Jax Spine & Pain Centers
Registry dates
- Enumerated
- 2020-09-02
- Last updated
- 2024-08-12
- Certified
- 2024-08-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.