Organization Active NPI

Florida Psychiatry Associates LLC

  • Psychiatry Physician
  • Port St Lucie, FL
National Provider Identifier
1306120456
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
FLORIDA PSYCHIATRY ASSOCIATES LLC
Practice address
260 NW Peacock Blvd Ste 102
Port St Lucie, FL 34986-2349
Phone
(772) 878-7216
Fax
(772) 878-7218
NPI assigned
Oct 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Authorized official

Name
Joanna Vanvleet, DO
Title
Owner
Phone
(772) 878-7216

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

260 NW Peacock Blvd Ste 102
Port St Lucie, FL 34986-2349

Mailing address

260 NW Peacock Blvd Ste 102
Port St Lucie, FL 34986-2349
Phone (772) 878-7216

Other practice location 1

1555 NW Saint Lucie West Blvd
201
Port St Lucie, FL 34986-1758
Phone (772) 878-7216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120607000228 FL Part B Supplier - Clinic/Group Practice 0345404166 Receives reassigned benefits from 8 practitioners
Practice locations: Port Saint Lucie, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1306120456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 NW PEACOCK BLVD STE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862349",
            "telephone_number": "772-878-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 NW PEACOCK BLVD STE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862349",
            "telephone_number": "772-878-7216",
            "fax_number": "772-878-7218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1555 NW Saint Lucie West Blvd",
            "address_2": "201",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349861758",
            "country_code": "US",
            "telephone_number": "772-878-7216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FLORIDA PSYCHIATRY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "VANVLEET",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-878-7216",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.