Primecare PL

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

ME58662 Issued in FL

Legal business name

PRIMECARE PL

Practice address

2720 US Highway 1 S # B
St Augustine, FL 32086-6301

Phone

(904) 827-0078

Fax

(904) 827-0140

NPI assigned

Dec 4, 2007

Organization subpart

No

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

Authorized official

Name

Robert C Kelsey, MDNPI 1831284306

Title

President

Phone

(904) 827-0078

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert C Kelsey, MD

  • Cardiovascular Disease Physician
  • St Augustine, FL
  • NPI 1831284306
  Medicare reassignment Care Compare group NPD Authorized official
• Chelsea Blais, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1790480663
  Medicare reassignment Care Compare group NPD
• Barbara A Thomas, APRN

  • Family Nurse Practitioner
  • Saint Augustine, FL
  • NPI 1982305256
  Medicare reassignment Care Compare group NPD
• David Michael Wood, FNP-C

  • Family Nurse Practitioner
  • St Augustine, FL
  • NPI 1174254908
  Medicare reassignment Care Compare group NPD
• Phillip Alex Wimpelberg, PA

  • Medical Physician Assistant
  • St Augustine, FL
  • NPI 1871686352
  Medicare reassignment
• Melanie Marie Goodwin, APRN

  • Nurse Practitioner
  • St Augustine, FL
  • NPI 1902357858
  NPD

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1407038169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 US HIGHWAY 1 S # B",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866301",
            "telephone_number": "904-827-0078",
            "fax_number": "904-827-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2720 US HIGHWAY 1 S # B",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866301",
            "telephone_number": "904-827-0078",
            "fax_number": "904-827-0140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMECARE PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "KELSEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-827-0078",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME58662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270845101",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270845104",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270845106",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270845102",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "97705",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270845105",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Premiere Pilates Rehabilitation and Fitness
• Harry R Prevatt, PA
• Jennifer Price
• Samantha Price
• Ralph David Priddy, PA-C
• Bernice Prince Jr., RNFA
• John Edward Prioleau, MD
• Prizm Healthcare Services PA
• Pro Massage
• Sheila Proctor

• Cardiovascular Disease Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Cardiovascular Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.