St. Johns Vein Center, Inc.

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

ST. JOHNS VEIN CENTER, INC.

Practice address

8767 Perimeter Park Blvd
Jacksonville, FL 32216-5479

Phone

(904) 402-8346

Fax

(904) 402-8347

NPI assigned

Jun 4, 2010

Organization subpart

No

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

Authorized official

Name

Dr. James St. George, M.D.

Title

Ceo

Phone

(904) 402-8346

Specialties & licenses 2

Addresses

Other names 1

• Ancient City Vein & Vascular, Inc Former legal business name

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1275609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599609600000",
    "number": "1376863977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8767 PERIMETER PARK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165479",
            "telephone_number": "904-402-8346",
            "fax_number": "904-402-8347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8767 PERIMETER PARK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165479",
            "telephone_number": "904-402-8346",
            "fax_number": "904-402-8347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13241 Bartram Park Blvd Unit 101",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322585232",
            "country_code": "US",
            "telephone_number": "904-402-8346",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1677 Eagle Harbor Pkwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Fleming Island",
            "state": "FL",
            "postal_code": "320034845",
            "country_code": "US",
            "telephone_number": "904-402-8346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ST. JOHNS VEIN CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-04",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "ST. GEORGE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-402-8346",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Phlebology",
            "state": "FL",
            "license": "ME88184",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "referrals@stjohnsvein.ssdirect.aprima.com",
            "affiliation": "N",
            "address_1": "8767 Perimeter Park Blvd",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322165479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ancient City Vein & Vascular, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Ancient City Vein & Vascular, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Teresa Marie St. John, PT
• St. John'S Integrated Health, Inc.
• St. Johns Bluff Family Practice
• St. Johns Interventional and Vascular Institute
• St. Johns River Rural Health Network
• St. Levon Haven, LLC
• Adrienne St. Louis
• St. Vincent'S First Care
• St. Vincent'S First Care-Normandy
• St. Vincent'S First Care-Ortega

• All providers in Jacksonville, FL
• Vascular & Interventional Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.