Fleming Island Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

PENDING Issued in FL

Legal business name

FLEMING ISLAND SURGERY CENTER

Practice address

1670 Eagle Harbor Pkwy
Suite B
Orange Park, FL 32003-4806

Phone

(904) 541-3048

Fax

(904) 215-7960

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Tara Shea McLaughlin

Title

Director of Contracting

Phone

(727) 785-9800

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Harris Wilcox and Donovan PA

  • Ophthalmology Physician
  • Jacksonville, FL
  • NPI 1346539988

  Member Of

  NPD member

Locations

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

• Michael S. Gilligan, M.D.

  • Surgery Physician
  • Orange Park, FL
  • NPI 1558329789
  NPD (past)

Listed as

Fleming Island Surgery CenterCCN 10C0001483

Medicare certification status

ActiveFrom the Provider of Services file

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457428005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 EAGLE HARBOR PKWY",
            "address_2": "SUITE B",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320034806",
            "telephone_number": "904-541-3048",
            "fax_number": "904-215-7960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 EAGLE HARBOR PKWY",
            "address_2": "SUITE B",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320034806",
            "telephone_number": "904-541-3048",
            "fax_number": "904-215-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLEMING ISLAND SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCLAUGHLIN",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "SHEA",
        "authorized_official_title_or_position": "DIRECTOR OF CONTRACTING",
        "authorized_official_telephone_number": "727-785-9800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PENDING",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Flemens
• Fleming Island 2020 PA
• Fleming Island Anesthesia LLC
• Fleming Island Family Chiropractic
• Fleming Island Family Dentistry, PA
• Fleming Island Vision Center
• John M Flinchbaugh, D.O.
• Tiffany Reshae Florence, ARNP
• Florida Autism Center
• Florida Autism Center

• All providers in Orange Park, FL
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.