St. Johns Interventional and Vascular Institute

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

Legal business name

ST. JOHNS INTERVENTIONAL AND VASCULAR INSTITUTE

Practice address

8767 Perimeter Park Blvd
Jacksonville, FL 32216-5479

Phone

(904) 402-8346

Fax

(904) 402-8347

NPI assigned

Jan 9, 2018

Organization subpart

No

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

Authorized official

Name

James K St. George, M.D.

Title

Ceo

Phone

(904) 402-8346

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1515456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1447767686",
    "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": [],
    "basic": {
        "organization_name": "ST. JOHNS INTERVENTIONAL AND VASCULAR INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-09",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "ST. GEORGE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-402-8346",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Vincents Physician Enterprise Inc
• Matthew Tyler St. George, RD
• Teresa Marie St. John, PT
• St. John'S Integrated Health, Inc.
• St. Johns Bluff Family Practice
• St. Johns River Rural Health Network
• St. Johns Vein Center, Inc.
• St. Levon Haven, LLC
• Adrienne St. Louis
• St. Vincent'S First Care

• All providers in Jacksonville, FL
• Vascular & Interventional Radiology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; 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.