NPIMap

Organization Active NPI

Crescent Beach Care LLC

  • Family Medicine Physician
  • St Augustine, FL
National Provider Identifier
1033451380
Registry record updated Dec 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CRESCENT BEACH CARE LLC
Practice address
6573 A1A South
St Augustine, FL 32080
Phone
(904) 342-7363
Fax
(904) 342-7367
NPI assigned
Mar 25, 2013
Last updated
Dec 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2025

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

Authorized official

Name
Dr. Adrian S. Long, MDNPI 1346407962
Title
Owner/Member Managed
Phone
(904) 342-7363

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6573 A1A South
St Augustine, FL 32080

Mailing address

6573 A1A South
St Augustine, FL 32080
Phone (904) 342-7363

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130710000292 FL Part B Supplier - Clinic/Group Practice 5991945289 Receives reassigned benefits from 5 practitioners
Practice locations: St Augustine, FL; St. Augustine, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1364169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764806400000",
    "number": "1033451380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6573 A1A SOUTH",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "32080",
            "telephone_number": "904-342-7363",
            "fax_number": "904-342-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6573 A1A SOUTH",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "32080",
            "telephone_number": "904-342-7363",
            "fax_number": "904-342-7367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESCENT BEACH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-25",
        "last_updated": "2025-12-04",
        "certification_date": "2025-12-04",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "ADRIAN",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER/MEMBER MANAGED",
        "authorized_official_telephone_number": "904-342-7363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.