NPIMap

Organization Active NPI

St Vincents Ambulatory Care Inc

  • Rural Health Clinic/Center
  • Hilliard, FL
National Provider Identifier
1558344978
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
ST VINCENTS AMBULATORY CARE INC
Practice address
551616 US Highway 1
Hilliard, FL 32046-8281
Phone
(904) 845-3574
Fax
(904) 845-7418
NPI assigned
Nov 21, 2005
Last updated
Aug 26, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Authorized official

Name
Linda E Gooden
Title
Amg Administration
Phone
(904) 450-8288

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X NU Primary
Family Nurse Practitioner 363LF0000X ARNP1440112 FL

Addresses

Primary practice location

551616 US Highway 1
Hilliard, FL 32046-8281

Mailing address

551616 US Highway 1
Hilliard, FL 32046-8281
Phone (904) 845-3574

Other names 1

  • Hilliard Medical Center, Inc. Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558344978. Details of each certification follow.

Rural health clinic certification: CCN 108909

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ST VINCENT'S AMBULATORY CARE INC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Jan 31, 1999
Last certification
Sep 21, 2016
Ownership / control type
1B
Most recent change of ownership
Apr 1, 2007 (3 total)
Facility address
551616 US Hwy 1
Hilliard, FL 32046

National Provider Directory

National Provider Directory
Tax ID family
St Vincents Ambulatory Care Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member of 2

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

Locations

10250 Normandy Blvd
Ste 800
Jacksonville, FL 32221
Phone (904) 786-5141

11512 Lake Mead Ave
Bldg 501
Jacksonville, FL 32256
Phone (904) 308-3667

12311 San Jose Blvd
Jacksonville, FL 32223
Phone (904) 262-7211

2 Shircliff Way
Ste 533
Jacksonville, FL 32204
Phone (904) 384-7370

4203 Belfort Rd
Ste 315
Jacksonville, FL 32216
Phone (904) 296-0400

700 3rd St
Ste 301
Neptune Beach, FL 32266
Phone (904) 241-5331

Practitioners & affiliated clinicians

Practitioners 3

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": "1132531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1558344978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551616 US HIGHWAY 1",
            "city": "HILLIARD",
            "state": "FL",
            "postal_code": "320468281",
            "telephone_number": "904-845-3574",
            "fax_number": "904-845-7418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551616 US HIGHWAY 1",
            "city": "HILLIARD",
            "state": "FL",
            "postal_code": "320468281",
            "telephone_number": "904-845-3574",
            "fax_number": "904-845-7418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST VINCENTS AMBULATORY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-21",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "GOODEN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "AMG ADMINISTRATION",
        "authorized_official_telephone_number": "904-450-8288"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP1440112",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hilliard Medical Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Hilliard Medical Center, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Hilliard, FL

Sources for this page

Verify at the official NPI Registry.