St. Augustine Artificial Kidney Center, LTD.

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

ST. AUGUSTINE ARTIFICIAL KIDNEY CENTER, LTD.

Practice address

264 Southpark Cir E
St Augustine, FL 32086-5137

Phone

(904) 808-0445

Fax

(904) 808-0446

NPI assigned

Jan 19, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Vicki L Burrier, RN, MBA

Title

Director/Vice-President

Phone

(954) 474-7701

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013997600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7061 CYPRESS RD",
            "address_2": "SUITE 104",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172243",
            "telephone_number": "954-474-7701",
            "fax_number": "954-474-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 SOUTHPARK CIR E",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865137",
            "telephone_number": "904-808-0445",
            "fax_number": "904-808-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. AUGUSTINE ARTIFICIAL KIDNEY CENTER, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURRIER",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR/VICE-PRESIDENT",
        "authorized_official_telephone_number": "954-474-7701",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, MBA"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER NO.",
            "identifier": "V7A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• St. Augustine Direct Primary Care, LLC
• St. Augustine Ear, Nose & Throat, L.L.C.
• St. Augustine Foot & Ankle, Inc
• St. Augustine Foot & Ankle, Inc
• St. Augustine Foot & Ankle, Inc.

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in St Augustine, FL
• Providers in St Augustine, FL by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.