1518768548 NPI number — ONCOPELVIC PT, LLC

Table of content: DR. GREGORY LAWRENCE GEERS M.D. (NPI 1174795058)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518768548 NPI number — ONCOPELVIC PT, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONCOPELVIC PT, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1518768548
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/12/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3832 BAYMEADOWS RD
Provider Second Line Business Mailing Address:
SUITE 10 #179
Provider Business Mailing Address City Name:
JACKSONVILLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32217-5605
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
904-544-9140
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4241 BAYMEADOWS RD STE 16
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32217-4674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-544-9140
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/24/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HILL
Authorized Official First Name:
ALEXANDRA
Authorized Official Middle Name:
DIONNE
Authorized Official Title or Position:
PHYSICAL THERAPIST, OWNER
Authorized Official Telephone Number:
904-544-9140

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)