NPIMap

Organization Active NPI

St Vincent'S Full Service Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1346057718
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
ST VINCENT'S FULL SERVICE URGENT CARE, LLC
Practice address
10058 Baymeadows Rd
Jacksonville, FL 32256-7177
Phone
(904) 450-8020
Fax
(904) 450-8004
NPI assigned
Dec 18, 2024
Organization subpart
Yes
Parent organization
ST VINCENT'S FULL SERVICE URGENT CARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Authorized official

Name
Miranda Hemm
Title
Enrollment Manager
Phone
(904) 450-6004

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

10058 Baymeadows Rd
Jacksonville, FL 32256-7177

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6004

Other names 1

  • Ascension St. Vincent's Urgent Care - Baymeadows Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2178997St Vincent'S Ambulatory Care Inc10058 Baymeadows Road, Jacksonville, FL 32256Certificate of waiverFeb 12, 2028
10D2322669Ascension St Vincents Urgent Care Baymeadows10058 Baymeadows Rd Suite B, Jacksonville, FL 32256Certificate of waiverApr 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
St Vincents Full Service Ur11 organizations share this tax ID, including this one
Part of
St Vincents Full Service Ur

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1734480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1346057718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10058 BAYMEADOWS RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567177",
            "telephone_number": "904-450-8020",
            "fax_number": "904-450-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST VINCENT'S FULL SERVICE URGENT CARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST VINCENT'S FULL SERVICE URGENT CARE, LLC",
        "enumeration_date": "2024-12-18",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "HEMM",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "904-450-6004"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension St. Vincent's Urgent Care - Baymeadows",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 18, 2024; 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.