Organization Active NPI

St. Johns Vein Center, Inc.

  • Vascular & Interventional Radiology Physician
  • Jacksonville, FL
National Provider Identifier
1376863977
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
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
Last updated
Sep 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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.NPI 1730189739
Title
Ceo
Phone
(904) 402-8346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 202K00000X ME88184 FL
Vascular & Interventional Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0204X Primary

Addresses

Primary practice location

8767 Perimeter Park Blvd
Jacksonville, FL 32216-5479

Mailing address

8767 Perimeter Park Blvd
Jacksonville, FL 32216-5479
Phone (904) 402-8346

Other practice location 1

13241 Bartram Park Blvd Unit 101
Jacksonville, FL 32258-5232
Phone (904) 402-8346

Other practice location 2

1677 Eagle Harbor Pkwy Ste A
Fleming Island, FL 32003-4845
Phone (904) 402-8346

Other names 1

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

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address referrals@stjohnsvein.ssdirect.aprima.com

National Provider Directory

National Provider Directory

Interoperability endpoints

  • Direct secure messaging: referrals@stjohnsvein.ssdirect.aprima.com

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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"
        }
    ]
}

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 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.