Organization Active NPI

VMD Primary Providers Central Florida PLLC

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1215696158
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VMD PRIMARY PROVIDERS CENTRAL FLORIDA PLLC
Practice address
5340 Soutel Dr
Jacksonville, FL 32219-3478
Phone
(407) 798-8800
Fax
(321) 333-4292
NPI assigned
Dec 8, 2021
Organization subpart
Yes
Parent organization
VMD PRIMARY PROVIDERS CENTRAL FLORIDA PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Authorized official

Name
Rebecca Rager
Title
Director Revenue Cycle
Phone
(844) 969-0686

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

5340 Soutel Dr
Jacksonville, FL 32219-3478

Mailing address

4650 Westway Park Blvd
Houston, TX 77041-2007

Other names 1

  • Village Medical - Lincoln Villas Other name

National Provider Directory

National Provider Directory
Tax ID family
VMD Primary Providers Central Florida PLLC53 organizations share this tax ID, including this one
Part of
VMD Primary Providers Central Florida PLLC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1215696158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 WESTWAY PARK BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770412007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5340 SOUTEL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322193478",
            "telephone_number": "407-798-8800",
            "fax_number": "321-333-4292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VMD PRIMARY PROVIDERS CENTRAL FLORIDA PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "VMD PRIMARY PROVIDERS CENTRAL FLORIDA PLLC",
        "enumeration_date": "2021-12-08",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "RAGER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "DIRECTOR REVENUE CYCLE",
        "authorized_official_telephone_number": "844-969-0686"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Medical - Lincoln Villas",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Village Medical - Lincoln Villas",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jan 14, 2025; 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.