NPIMap

Organization Active NPI

Foundations Pediatrics Assessment and Treatment Center

  • Adolescent and Children Mental Health Clinic/Center
  • Saint Augustine, FL
National Provider Identifier
1245086040
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
FOUNDATIONS PEDIATRICS ASSESSMENT AND TREATMENT CENTER
Practice address
245 Land Grant Street
Suite 3
Saint Augustine, FL 32092
Phone
(904) 370-3420
NPI assigned
Apr 24, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Authorized official

Name
Jill DriestNPI 1083041925
Title
Owner
Phone
(904) 370-3420

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

245 Land Grant Street
Suite 3
Saint Augustine, FL 32092

Mailing address

247 Orchard LN
Saint Augustine, FL 32095-0031
Phone (954) 895-3006

National Provider Directory

National Provider Directory
Tax ID family
Foundations Pediatrics Assessment and Treatment Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713916800000",
    "number": "1245086040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 ORCHARD LN",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320950031",
            "telephone_number": "954-895-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 LAND GRANT STREET",
            "address_2": "SUITE 3",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "32092",
            "telephone_number": "904-370-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATIONS PEDIATRICS ASSESSMENT AND TREATMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "DRIEST",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-370-3420"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.