NPIMap

Organization Active NPI

Physicians Group Services PA

Doing business as Coastal Health

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1497118160
Registry record updated Jul 29, 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
Coastal Health Primary Care
Practice address
14810 Old Saint Augustine Rd Ste 208
Jacksonville, FL 32258-2558
Phone
(904) 260-4111
Fax
(904) 301-9115
NPI assigned
Mar 31, 2016
Last updated
Jul 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X

Addresses

Primary practice location

14810 Old Saint Augustine Rd Ste 208
Jacksonville, FL 32258-2558

Mailing address

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

Other names 2

  • Coastal Health Doing business as
  • Coastal Health Primary Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031216000099 FL Part B Supplier - Clinic/Group Practice 1254238579 Receives reassigned benefits from 150 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL; Lake City, FL; Middleburg, FL; Orange Park, FL; Yulee, FL; Fernandina Beach, FL; Fleming Island, FL
O20130213000072 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).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0998246Physicians Group Services PA14810 Old St Augustine Rd Ste 207, Jacksonville, FL 32258Certificate of waiverApr 9, 2028

National Provider Directory

National Provider Directory

Locations

1865 Lime St
Ste 100
Fernandina Beach, FL 32034
Phone (904) 277-2052

Practitioners & affiliated clinicians

Practitioners 11

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": "1459382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753747200000",
    "number": "1497118160",
    "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": "14810 OLD SAINT AUGUSTINE RD STE 208",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582558",
            "telephone_number": "904-260-4111",
            "fax_number": "904-301-9115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS GROUP SERVICES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-31",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Health Primary Care",
            "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 Jul 29, 2025; 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.