NPIMap

Organization Active NPI

St. Vincent'S First Care-Ortega

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1386077006
Registry record updated Aug 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ST. VINCENT'S FIRST CARE-ORTEGA
Practice address
5501 Roosevelt Blvd
Jacksonville, FL 32244-2345
Phone
(904) 450-8100
Fax
(904) 981-0051
NPI assigned
Aug 16, 2013
Organization subpart
Yes
Parent organization
ST. VINCENT'S FIRST CARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 16, 2013

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

Authorized official

Name
Mr. Mark Reddinger
Title
Chief Operating Officer
Phone
(904) 379-1203

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Primary Care Clinic/Center 261QP2300X
Occupational Medicine Clinic/Center 261QX0100X

Addresses

Primary practice location

5501 Roosevelt Blvd
Jacksonville, FL 32244-2345

Mailing address

PO Box 551281
Jacksonville, FL 32255-1281
Phone (904) 450-8100

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.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1376611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376611200000",
    "number": "1386077006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 551281",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322551281",
            "telephone_number": "904-450-8100",
            "fax_number": "904-981-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 ROOSEVELT BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322442345",
            "telephone_number": "904-450-8100",
            "fax_number": "904-981-0051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT'S FIRST CARE-ORTEGA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. VINCENT'S FIRST CARE, LLC",
        "enumeration_date": "2013-08-16",
        "last_updated": "2013-08-16",
        "status": "A",
        "authorized_official_last_name": "REDDINGER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "904-379-1203",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 16, 2013; 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.