Organization Active NPI

Center for Health & Sports Medicine LLC

  • Family Medicine Physician
  • Fruit Cove, FL
National Provider Identifier
1386963932
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME89577 Issued in FL
Legal business name
CENTER FOR HEALTH & SPORTS MEDICINE LLC
Practice address
201 Village Oaks Dr
Fruit Cove, FL 32259-3876
Phone
(904) 240-0442
Fax
(904) 240-0471
NPI assigned
May 21, 2010
Last updated
Mar 28, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Authorized official

Name
Dr. Ross Osborn, MDNPI 1528042496
Title
Owner
Phone
(904) 240-0442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU
Family Medicine Physician 207Q00000X ME89577 FL Primary

Addresses

Primary practice location

201 Village Oaks Dr
Fruit Cove, FL 32259-3876

Mailing address

201 Village Oaks Dr
Fruit Cove, FL 32259-3876
Phone (904) 240-0442

Other practice location 1

4255 US 1 S Ste 10
St Augustine, FL 32086-7000
Phone (904) 240-0565

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100715000226 FL Part B Supplier - Clinic/Group Practice 0547392201 Receives reassigned benefits from 12 practitioners
Practice locations: Saint Johns, FL

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
10D2008197Center for Health and Sports Medicine201 Village Oaks Dr, Jacksonville, FL 32259Certificate of waiverJan 26, 2028
10D2258771Center for Health & Sports Medicine, LLC4255 US Highway 1 South, Unit 10, St Augustine, FL 32086Certificate of waiverApr 26, 2028

National Provider Directory

National Provider Directory

Locations

4255 US Highway 1 S
Ste 10
Saint Augustine, FL 32086
Phone (904) 240-0442

115 Bartram Oaks Walk
Ste 104
St Johns, FL 32259
Phone (904) 240-0442

201 Village Oaks Dr
St Johns, FL 32259
Phone (904) 240-0442

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8428/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1274400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743120000000",
    "number": "1386963932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 VILLAGE OAKS DR",
            "city": "FRUIT COVE",
            "state": "FL",
            "postal_code": "322593876",
            "telephone_number": "904-240-0442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 VILLAGE OAKS DR",
            "city": "FRUIT COVE",
            "state": "FL",
            "postal_code": "322593876",
            "telephone_number": "904-240-0442",
            "fax_number": "904-240-0471"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4255 US 1 S Ste 10",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320867000",
            "country_code": "US",
            "telephone_number": "904-240-0565",
            "fax_number": "904-240-0471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTER FOR HEALTH & SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-21",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A",
        "authorized_official_last_name": "OSBORN",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-240-0442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME89577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruit Cove, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.