NPIMap

Organization Active NPI

Avecina Medical PA

  • Urgent Care Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1215082003
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
ME88018 Issued in FL
Legal business name
AVECINA MEDICAL PA
Practice address
1633 Race Track Rd
Suite 1
Jacksonville, FL 32259-3234
Phone
(904) 230-6988
Fax
(904) 342-4028
NPI assigned
Jan 24, 2007
Organization subpart
No

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) 367-3372

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X ME88018 FL Primary

Addresses

Primary practice location

1633 Race Track Rd
Suite 1
Jacksonville, FL 32259-3234

Mailing address

4815 Sweetgrass PL Ste 201
Jacksonville, FL 32224-0131
Phone (904) 367-3373

Other practice location 1

4160 Southside Blvd # 10
Jacksonville, FL 32216-8500
Phone (904) 900-1717

Other practice location 2

5915 Normandy Blvd
Jacksonville, FL 32205-6200
Phone (904) 379-8085

Other practice location 3

9580 Applecross Rd Ste 106
Jacksonville, FL 32222-5843
Phone (904) 778-9180

Other identifiers 2

IdentifierTypeStateIssuer
006670000MedicaidFL
006670005MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address avecinamed@AMP-IL.direct.office.nextgen.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

9925 San Jose Blvd
Ste 1
Jacksonville, FL 32257
Phone (904) 328-5504

4815 Sweetgrass Pl
Unit 201
Jacksonville, FL 32224
Phone (904) 367-3372

1633 Race Track Rd
Ste 1
Jacksonville, FL 32259
Phone (904) 230-6988

Interoperability endpoints

  • Direct secure messaging: avecinamed@amp-il.direct.office.nextgen.com

Practitioners & affiliated clinicians

Practitioners 85

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 85

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1215082003",
    "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",
            "telephone_number": "904-367-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1633 RACE TRACK RD",
            "address_2": "SUITE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322593234",
            "telephone_number": "904-230-6988",
            "fax_number": "904-342-4028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4160 Southside Blvd # 10",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322168500",
            "country_code": "US",
            "telephone_number": "904-900-1717",
            "fax_number": "904-367-2143",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5915 Normandy Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322056200",
            "country_code": "US",
            "telephone_number": "904-379-8085",
            "fax_number": "904-619-8042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9580 Applecross Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322225843",
            "country_code": "US",
            "telephone_number": "904-778-9180",
            "fax_number": "904-778-9740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AVECINA MEDICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "MORETTI KIGHT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "904-367-3372"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "FL",
            "license": "ME88018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006670000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006670005",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avecinamed@AMP-IL.direct.office.nextgen.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1633 Race Track Rd Ste 101",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322593237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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.