Individual provider · Type 1 NPI

Kelly M. Bumgarner, PA-C

Physician Assistant · Jacksonville Beach, FL

NPI number 1548714728 Active

Practice location

1320 Roberts Dr Ste 101
Jacksonville Beach, FL 32250-3253

Call (904) 241-7147 Map

Fax (904) 376-3213

Mailing address

PO Box 746652
Atlanta, GA 30374-6652

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XPA9109484 (FL)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1548714728

Kelly M. Bumgarner, PA-C's National Provider Identifier is 1548714728, issued on Aug 5, 2016. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Jacksonville Beach, FL. The record was last updated on Nov 13, 2025.