NPIMap

Organization Active NPI

Florida Department of Health

Doing business as St Johns County Health Department

  • Public Health or Welfare Agency
  • St Augustine, FL
National Provider Identifier
1023081932
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
FLORIDA DEPARTMENT OF HEALTH
Doing business as
St Johns County Health Department
Practice address
200 San Sebastian VW
St Augustine, FL 32084-8695
Phone
(904) 506-6081
Fax
(904) 825-6875
NPI assigned
Feb 10, 2006
Last updated
Apr 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Shane Lockwood
Title
Health Officer
Phone
(904) 506-6153

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

200 San Sebastian VW
St Augustine, FL 32084-8695

Mailing address

200 San Sebastian VW
St Augustine, FL 32084-8695
Phone (904) 506-6081

Other names 1

  • St Johns County Health Department Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040724000002 FL Part B Supplier - Clinic/Group Practice 3072424282 Receives reassigned benefits from 10 practitioners
Practice locations: Saint Augustine, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0884169Florida Department of Health in St Johns County200 San Sebastian View, Saint Augustine, FL 32084Certificate of waiverApr 11, 2028

National Provider Directory

National Provider Directory

Locations

200 San Sebastian Vw
Ste 1322
Saint Augustine, FL 32084

200 San Sebastian Vw
St Augustine, FL 32084
Phone (904) 209-3250

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Walton Community Health CenterDefuniak Springs, FL, CCN 101136 Federally qualified health center Operational/Managerial Control (100%) Sep 7, 2010
Bradford Community Health Care IncStarke, FL, CCN 101182 Federally qualified health center Operational/Managerial Control (100%) Oct 1, 2013

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1023081932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SAN SEBASTIAN VW",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320848695",
            "telephone_number": "904-506-6081",
            "fax_number": "904-825-6875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SAN SEBASTIAN VW",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320848695",
            "telephone_number": "904-506-6081",
            "fax_number": "904-825-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DEPARTMENT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-10",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "LOCKWOOD",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "904-506-6153"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Johns County Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.