NPIMap

Organization Active NPI

Flagler Family Medicine P a

Doing business as Northeast Florida Foot and Ankle

  • Podiatrist
  • St Augustine, FL
National Provider Identifier
1538646757
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
FLAGLER FAMILY MEDICINE P A
Doing business as
Northeast Florida Foot and Ankle
Practice address
52 Tuscan Way Ste 205
St Augustine, FL 32092-1850
Phone
(904) 826-3469
NPI assigned
Jul 20, 2018
Last updated
Jul 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Authorized official

Name
Warren Whitlock, MDNPI 1538126156
Title
Authorized Official / Partner
Phone
(904) 826-3469

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X Primary

Addresses

Primary practice location

52 Tuscan Way Ste 205
St Augustine, FL 32092-1850

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
252488100MedicaidFL

Other names 1

  • Northeast Florida Foot and Ankle Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Flagler Family Medicine P a2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1532044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1538646757",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 TUSCAN WAY STE 205",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320921850",
            "telephone_number": "904-826-3469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLAGLER FAMILY MEDICINE P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "WHITLOCK",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL / PARTNER",
        "authorized_official_telephone_number": "904-826-3469",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252488100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Florida Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 20, 2018; 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.