Organization Active NPI

Qixia Huang, M.D., P.a.

  • Clinic/Center
  • St Augustine, FL
National Provider Identifier
1467649632
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
ME78764 Issued in FL
Legal business name
QIXIA HUANG, M.D., P.A.
Practice address
1301 Plantation Island Dr S Ste 102a
St Augustine, FL 32080-3109
Phone
(904) 471-5626
NPI assigned
Oct 1, 2007
Last updated
Oct 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Authorized official

Name
Dr. Qixia Huang, M.D.NPI 1215039870
Title
President
Phone
(904) 471-5626

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X ME78764 FL Primary

Addresses

Primary practice location

1301 Plantation Island Dr S Ste 102a
St Augustine, FL 32080-3109

Mailing address

1301 Plantation Island Dr S Ste 102a
St Augustine, FL 32080-3109
Phone (904) 471-5626

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040625000219 FL Part B Supplier - Clinic/Group Practice 6608852264 Receives reassigned benefits from 1 practitioner
Practice locations: St Augustine, FL

National Provider Directory

National Provider Directory

Locations

1301 Plantation Island Dr S
Ste 102A
Saint Augustine, FL 32080
Phone (904) 471-5626

Practitioners & affiliated clinicians

Practitioners 1

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": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1467649632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S STE 102A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320803109",
            "telephone_number": "904-471-5626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 PLANTATION ISLAND DR S STE 102A",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320803109",
            "telephone_number": "904-471-5626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QIXIA HUANG, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "HUANG",
        "authorized_official_first_name": "QIXIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-471-5626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "ME78764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; 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.