Pediatric Associates of Julington Creek

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC ASSOCIATES OF JULINGTON CREEK

Practice address

1631 Race Track Rd Ste 101
Jacksonville, FL 32259-3233

Phone

(904) 230-7977

Fax

(904) 230-7979

NPI assigned

Jan 31, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mary Ann Garcia, M.D.NPI 1447258058

Title

Ceo

Phone

(904) 230-7977

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JCFAAA

Practitioners 5

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.

• Mary Ann Garcia, M.D.

  • Pediatrics Physician
  • Jacksonville, FL
  • NPI 1447258058
  NPD (past) Authorized official
• Claire Solomon Basco, APRN

  • Pediatric Nurse Practitioner
  • Jacksonville, FL
  • NPI 1831725530
  NPD (past)
• Victor Joseph Luz, MD

  • Pediatrics Physician
  • Jacksonville, FL
  • NPI 1932272291
  NPD (past)
• Tami Leigh Newbern, ARNP

  • Pediatric Nurse Practitioner
  • Saint Johns, FL
  • NPI 1871888073
  NPD (past)
• Raquel Stelzer, APRN

  • Pediatric Nurse Practitioner
  • Fruit Cove, FL
  • NPI 1003529173
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235276254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 RACE TRACK ROAD SUITE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32259",
            "telephone_number": "904-230-7977",
            "fax_number": "904-230-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 RACE TRACK RD STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322593233",
            "telephone_number": "904-230-7977",
            "fax_number": "904-230-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF JULINGTON CREEK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-230-7977",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Elizabeth Pedersen
• Nicole Marie Pedersen, FNP
• Stephen Mark Pederson
• Pediatric Associates at Argyle PA
• Pediatric Associates at Argyle PA
• Pediatric Associates of NE Florida, LLC (Jacksonville Pediatric Associates)
• Pediatric Associates of NE Florida, LLC (Jacksonville Pediatric Associates)
• Pediatric Care Centers, LLC (24/7 Pediatric Care Centers)
• Pediatric Center for Excellence, LLC
• Pediatric Innovation Center, LLC

• Pediatrics Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.