Ancient City Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

ANCIENT CITY PEDIATRICS

Doing business as

DBA Sunshine Pediatrics of St Augustine

Practice address

1301 Plantation Island Dr S Ste 104
Saint Augustine, FL 32080-3108

Phone

(904) 461-1560

Fax

(904) 461-4304

NPI assigned

Jan 30, 2008

Last updated

Sep 2, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adrienne McCoy

Title

Office Manager

Phone

(904) 461-1560

Specialties & licenses 1

Addresses

Other names 1

• DBA Sunshine Pediatrics of St Augustine Doing business as

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

CLIA laboratory certificates

Tax ID family

Ancient City Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Shelby H Cline MD PA D/B/a Sunshine Pediatrics of St Augustine

  • Pediatrics Physician
  • St Augustine, FL
  • NPI 1902663735
  NPD tax ID

Locations

Practitioners 1

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.

• Jacqueline Megan Bejtullahu, MD

  • Pediatrics Physician
  • St Augustine, FL
  • NPI 1447645718
  NPD (past)

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1053598292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S STE 104",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320803108",
            "telephone_number": "904-461-1560",
            "fax_number": "904-461-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S STE 104",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320803108",
            "telephone_number": "904-461-1560",
            "fax_number": "904-461-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANCIENT CITY PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2025-09-02",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-461-1560"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Sunshine Pediatrics of St Augustine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ancient City Acupuncture and Herbal Medicine
• Ancient City Children's Therapy, LLC
• Ancient City Diagnostics, LLC
• Ancient City Midwives Inc
• Ancient City Mobile Physical Therapy LLC
• And Then There Is You for North Florida PLLC (And Then There is You - Intergrated Health and Development)
• Megan E Andersen, APRN
• Geneva J Anderson
• Jasmine Anderson
• Luis M Anderson, M.D.

• Pediatrics Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.