NPIMap

Organization Active NPI

Physicians Group Services PA

Doing business as Coastal Health

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1467616169
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PHYSICIANS GROUP SERVICES PA
Doing business as
Coastal Health
Family Medical Center San Pablo
Practice address
14011 Beach Blvd
Suite 120
Jacksonville, FL 32250-1507
Phone
(904) 223-6400
Fax
(904) 223-6420
NPI assigned
Jul 11, 2008
Last updated
May 30, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PHYSICIANS GROUP SERVICES PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Authorized official

Name
Andrew T Christman
Title
Ceo
Phone
(941) 685-7688

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU
Pediatric Clinical Nurse Specialist 364SP0200X NU
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

14011 Beach Blvd
Suite 120
Jacksonville, FL 32250-1507

Mailing address

705 Wells Rd Ste 300
Orange Park, FL 32073-2982
Phone (904) 282-6331

Other identifiers 1

IdentifierTypeStateIssuer
259123502MedicaidFL

Other names 2

  • Coastal Health Doing business as
  • Family Medical Center San Pablo Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241017000211 FL DME Supplier - Multi-Specialty - Physician 1254238579 Practice locations: Jacksonville, FL

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Physicians Group Servic22 organizations share this tax ID, including this one
Part of
Physicians Group Servic

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1467616169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 WELLS RD STE 300",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320732982",
            "telephone_number": "904-282-6331",
            "fax_number": "904-619-1080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14011 BEACH BLVD",
            "address_2": "SUITE 120",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322501507",
            "telephone_number": "904-223-6400",
            "fax_number": "904-223-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS GROUP SERVICES PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHYSICIANS GROUP SERVICES PA",
        "enumeration_date": "2008-07-11",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "CHRISTMAN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "941-685-7688"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "259123502",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Medical Center San Pablo",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Medical Center San Pablo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.