NPIMap

Organization Active NPI

Northeast Florida Primary Care Clinic

  • Family Medicine Physician
  • Orange Park, FL
National Provider Identifier
1235232273
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME0076341 Issued in FL
Legal business name
NORTHEAST FLORIDA PRIMARY CARE CLINIC
Practice address
1835 East-West Parkway
Suite 11
Orange Park, FL 32003
Phone
(904) 215-9266
Fax
(904) 264-4651
NPI assigned
Sep 6, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Jack Edward Pulwers Jr., MDNPI 1831128560
Title
President
Phone
(904) 215-9266

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X ME0076341 FL Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X ME0068123 FL

Addresses

Primary practice location

1835 East-West Parkway
Suite 11
Orange Park, FL 32003

Mailing address

1835 East-West Parkway
Suite 11
Orange Park, FL 32003
Phone (904) 215-9266

National Provider Directory

National Provider Directory

Locations

1540 Business Center Dr
Ste C
Orange Park, FL 32003
Phone (904) 215-9266

1835 Eastwest Pkwy
Ste 11
Orange Park, FL 32003
Phone (904) 215-3958

Practitioners & affiliated clinicians

Practitioners 3

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": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1235232273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 EAST-WEST PARKWAY",
            "address_2": "SUITE 11",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32003",
            "telephone_number": "904-215-9266",
            "fax_number": "904-264-4651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 EAST-WEST PARKWAY",
            "address_2": "SUITE 11",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32003",
            "telephone_number": "904-215-9266",
            "fax_number": "904-264-4651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST FLORIDA PRIMARY CARE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "PULWERS",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-215-9266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0076341",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0068123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.