SAMUEL J. FERN DO
NPI 1437136074
Family Medicine in Jacksonville Beach, FL

Q: What is Samuel Fern's NPI number?

The NPI number for Samuel Fern is 1437136074. It was assigned to this individual provider in the NPPES registry on December 26, 2005.

Q: What is Samuel Fern's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Fern was last updated on November 25, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 26, 2005

900 BEACH BLVD, CREDENTIALING DEPARTMENT, JACKSONVILLE BEACH, FL 32250(904) 249-0335(904) 249-0347 Get Directions Write a Review

NPPES record last updated: November 25, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Samuel J. Fern Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL J. FERN DO (NPI 1437136074) is an individual family medicine provider in Jacksonville Beach, Florida, licensed in Florida (OS6092) and active in the NPI registry since December 2005.

NPPES Registry Identity

NPI1437136074

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameSAMUEL J. FERNCredential: DO

Location Address900 BEACH BLVD, CREDENTIALING DEPARTMENTJacksonville Beach, FL 32250-4368

Mailing AddressPo Box 44004Jacksonville, FL 32231-4004 · (904) 202-1032 · Fax (904) 249-0347

Phone(904) 249-0335

Fax(904) 249-0347

Sole ProprietorNo

Enumeration DateDecember 26, 2005

Last NPPES UpdateNovember 25, 2015

✔ NPI 1437136074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in FL · OS6092

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

900 BEACH BLVD, Jacksonville Beach, FL 32250

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Other Identifiers 3

Medicare UPINE89696

Medicaid3704556-00FL

Medicare PIN80493YFL

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TONY VILLENA MD

Family Medicine

900 BEACH BLVD, CREDENTIALING DEPARTMENT
JACKSONVILLE BEACH, FL 32250

Duval County (904) 249-0335

MICHAEL D KRING PA

Physician Assistant