NPIMap

Individual provider Active NPI

Linda Sue Clonch, M.D.

  • Family Medicine Physician
  • St Augustine, FL
National Provider Identifier
1487611166
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME48434 Issued in FL
Practice address
130 Health Park Blvd
St Augustine, FL 32086-5776
Phone
(904) 826-3469
Fax
(904) 808-4608
NPI assigned
Apr 27, 2006
Last updated
Jul 23, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME48434 FL Primary

Addresses

Primary practice location

130 Health Park Blvd
St Augustine, FL 32086-5776

Mailing address

130 Health Park Blvd
St Augustine, FL 32086-5776
Phone (904) 826-3469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100716000809 FL Practitioner - Family Practice 3476685074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Flagler Family Medicine P aGroup PAC ID 9335114347, 13 clinicians

Practice addresses (Care Compare)

130 Health Park Blvd
St Augustine, FL 32086-5776
Phone (904) 826-3469

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME48434FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Flagler Family Medicine P a Family Medicine CurrentSince Jul 14, 1997 Accepting new patients
Flagler Family Nursing Home Care LLC Family Medicine CurrentSince May 1, 2021 Accepting new patients
Flagler Family Medicine PA Family Medicine CurrentSince Jul 14, 1997 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

130 Health Park Blvd
St Augustine, FL 32086
Phone (904) 826-3469

315 W Town Pl
Ste 1
St Augustine, FL 32092
Phone (904) 429-4736

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADBCAA
  • Direct secure messaging: linda.clonch@flaglerffm.eclinicaldirectplus.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216771200000",
    "number": "1487611166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865776",
            "telephone_number": "904-826-3469",
            "fax_number": "904-808-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865776",
            "telephone_number": "904-826-3469",
            "fax_number": "904-808-4608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLONCH",
        "first_name": "LINDA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2008-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME48434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.