NPIMap

Organization Active NPI

Family Care Partners of Northeast Florida LLC

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1417559147
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY CARE PARTNERS OF NORTHEAST FLORIDA LLC
Practice address
1215 Dunn Ave
Jacksonville, FL 32218-6330
Phone
(904) 757-1998
Fax
(904) 696-7462
NPI assigned
Nov 9, 2020
Last updated
Jan 3, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY CARE PARTNERS OF NORTHEAST FLORIDA, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Authorized official

Name
David Brown
Title
Secretary
Phone
(833) 702-8383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1215 Dunn Ave
Jacksonville, FL 32218-6330

Mailing address

425 W Colonial Dr Ste 303
Orlando, FL 32804-6863
Phone (904) 745-3618

National Provider Directory

National Provider Directory
Tax ID family
Family Care Prtnrs of N3 organizations share this tax ID, including this one
Part of
Family Care Prtnrs of N

Other organizations with this tax ID 2

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.

Practitioners & affiliated clinicians

Practitioners 4

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": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735862400000",
    "number": "1417559147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W COLONIAL DR STE 303",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328046863",
            "telephone_number": "904-745-3618",
            "fax_number": "904-722-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 DUNN AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186330",
            "telephone_number": "904-757-1998",
            "fax_number": "904-696-7462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CARE PARTNERS OF NORTHEAST FLORIDA LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY CARE PARTNERS OF NORTHEAST FLORIDA, LLC",
        "enumeration_date": "2020-11-09",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "833-702-8383"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Jan 3, 2025; 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.