St Johns Express Care PA

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME0044413 Issued in FL

Legal business name

ST JOHNS EXPRESS CARE PA

Practice address

880 A1A North
Suite 16
Ponte Vedra Beach, FL 32082

Phone

(904) 280-1300

Fax

(904) 280-1220

NPI assigned

Nov 14, 2006

Organization subpart

No

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

Authorized official

Name

Gerald Joseph Budd, MD

Title

President

Phone

(904) 280-1300

Specialties & licenses 1

Addresses

Other names 1

• Walk In Medical Care Other name

Locations

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477625515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 A1A NORTH",
            "address_2": "SUITE 16",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "32082",
            "telephone_number": "904-280-1300",
            "fax_number": "904-280-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 A1A NORTH",
            "address_2": "SUITE 16",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "32082",
            "telephone_number": "904-280-1300",
            "fax_number": "904-280-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST JOHNS EXPRESS CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUDD",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-280-1300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME0044413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walk In Medical Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Emergency Medicine Physician in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
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• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.