NPIMap

Organization Active NPI

First Coast Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1528197993
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FIRST COAST PRIMARY CARE INC
Practice address
4040 Woodcock Dr
Suite 250
Jacksonville, FL 32207-2720
Phone
(904) 400-6103
Fax
(904) 400-6102
NPI assigned
Mar 3, 2007
Last updated
Sep 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Authorized official

Name
Linda E Gooden
Title
Administration Manager
Phone
(904) 400-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

4040 Woodcock Dr
Suite 250
Jacksonville, FL 32207-2720

Mailing address

PO Box 61148
Jacksonville, FL 32236-1148
Phone (904) 400-6100

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4040 Woodcock Dr
Ste 250
Jacksonville, FL 32207
Phone (904) 400-6103

Practitioners & affiliated clinicians

Practitioners 73

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.

View all 73

NPI Registry JSON

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

{
    "created_epoch": "1172880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317168000000",
    "number": "1528197993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61148",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322361148",
            "telephone_number": "904-400-6100",
            "fax_number": "904-400-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 WOODCOCK DR",
            "address_2": "SUITE 250",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072720",
            "telephone_number": "904-400-6103",
            "fax_number": "904-400-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-03",
        "last_updated": "2011-09-28",
        "status": "A",
        "authorized_official_last_name": "GOODEN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATION MANAGER",
        "authorized_official_telephone_number": "904-400-6100"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 28, 2011; 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.