NPIMap

Organization Active NPI

Avecina Medical PA

  • Urgent Care Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1053981142
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
AVECINA MEDICAL PA
Practice address
4160 Southside Blvd
Jacksonville, FL 32216-8500
Phone
(904) 900-1717
Fax
(904) 367-2143
NPI assigned
Jun 30, 2021
Last updated
Jul 29, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
AVECINA MEDICAL PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Amanda Moretti Kight
Title
Billing Manager
Phone
(904) 723-4707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

4160 Southside Blvd
Jacksonville, FL 32216-8500

Mailing address

4815 Sweetgrass PL Ste 201
Jacksonville, FL 32224-0131

National Provider Directory

National Provider Directory
Part of
Avecina Medical PA

Locations

4160 Southside Blvd
Jacksonville, FL 32216
Phone (904) 900-1717

4160 Southside Blvd
#10
Jacksonville, FL 32216
Phone (904) 900-1717

Practitioners & affiliated clinicians

Practitioners 7

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": "1625011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1053981142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 SWEETGRASS PL STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 SOUTHSIDE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168500",
            "telephone_number": "904-900-1717",
            "fax_number": "904-367-2143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVECINA MEDICAL PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AVECINA MEDICAL PA",
        "enumeration_date": "2021-06-30",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-24",
        "status": "A",
        "authorized_official_last_name": "MORETTI KIGHT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "904-723-4707"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.