Organization Active NPI

Villages Regional Hospital Physician Services LLC

  • Urgent Care Clinic/Center
  • St Augustine, FL
National Provider Identifier
1083548861
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
VILLAGES REGIONAL HOSPITAL PHYSICIAN SERVICES LLC
Practice address
110 Health Park Blvd
St Augustine, FL 32086-5776
Phone
(904) 823-3401
NPI assigned
Jun 9, 2026
Last updated
Jun 30, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
VILLAGES REGIONAL HOSPITAL PHYSICIAN SERVICES LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Authorized official

Name
Heather Long
Title
SVP & Regional President
Phone
(352) 323-5001

Specialties & licenses 1

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

Addresses

Primary practice location

110 Health Park Blvd
St Augustine, FL 32086-5776

Mailing address

110 Health Park Blvd
St Augustine, FL 32086-5776
Phone (904) 823-3401

Other identifiers 1

IdentifierTypeStateIssuer
120400000MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Villages Regional Hospital Physician Services LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1780963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1083548861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865776",
            "telephone_number": "904-823-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865776",
            "telephone_number": "904-823-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGES REGIONAL HOSPITAL PHYSICIAN SERVICES LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VILLAGES REGIONAL HOSPITAL PHYSICIAN SERVICES LLC",
        "enumeration_date": "2026-06-09",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "SVP & REGIONAL PRESIDENT",
        "authorized_official_telephone_number": "352-323-5001"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120400000",
            "state": "FL"
        }
    ],
    "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 Jun 30, 2026; 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.