Island Doctors Intrastate LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

ISLAND DOCTORS INTRASTATE LLC

Practice address

100 Arricola Ave
Saint Augustine, FL 32080-4515

Phone

(904) 825-4368

Fax

(904) 825-9107

NPI assigned

Apr 27, 2020

Last updated

Apr 27, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Roy H Hinman Jr., MDNPI 1760595821

Title

Ceo and President

Phone

(904) 825-4368

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 94

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.

• Roy H Hinman, MD PA

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1760595821
  Medicare reassignment Care Compare group NPD Authorized official
• Dennis Arcangel Aglipay, APRN, FNP-BC

  • Family Nurse Practitioner
  • Pace, FL
  • NPI 1740990712
  Medicare reassignment Care Compare group NPD
• Walter Win Tun Ang, M.D

  • Internal Medicine Physician
  • Daytona Beach, FL
  • NPI 1558575696
  Medicare reassignment Care Compare group NPD
• Kathy Denese Bass

  • Acute Care Nurse Practitioner
  • Interlachen, FL
  • NPI 1609435239
  Medicare reassignment Care Compare group NPD
• Tammy L Blankenship, MD, MPH, MS

  • Public Health & General Preventive Medicine Physician
  • Tallahassee, FL
  • NPI 1285670216
  Medicare reassignment Care Compare group NPD
• Julie Bom Conselho, ARNP

  • Nurse Practitioner
  • Ormond Beach, FL
  • NPI 1356899587
  Medicare reassignment Care Compare group NPD
• Teresa Marie Brennan, D.O.

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1154391753
  Medicare reassignment Care Compare group NPD
• Michelle Lee Casto, ARNP

  • Adult Health Nurse Practitioner
  • Palatka, FL
  • NPI 1578937843
  Medicare reassignment Care Compare group NPD
• Canice Chukwuocha, MD

  • General Practice Physician
  • Palm Coast, FL
  • NPI 1376151472
  Medicare reassignment Care Compare group NPD
• Leslie Colombani, M.D.

  • General Practice Physician
  • East Palatka, FL
  • NPI 1205951175
  Medicare reassignment Care Compare group NPD
• Marilu Colon, M.D.

  • Rheumatology Physician
  • St Augustine, FL
  • NPI 1295842862
  Medicare reassignment Care Compare group NPD
• Stephanie Concepcion, M.D.

  • General Practice Physician
  • Orange Park, FL
  • NPI 1114137510
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587945600000",
    "number": "1568083889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ARRICOLA AVE",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320804515",
            "telephone_number": "904-825-4368",
            "fax_number": "904-825-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ARRICOLA AVE",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320804515",
            "telephone_number": "904-825-4368",
            "fax_number": "904-825-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND DOCTORS INTRASTATE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-27",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "HINMAN",
        "authorized_official_first_name": "ROY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CEO AND PRESIDENT",
        "authorized_official_telephone_number": "904-825-4368",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrative Pain Solutions, PL
• Interim HHA of St Augustine Inc
• Internal Medicine Associates of St Johns County PA
• Intuition Wellness, LLC
• Julia Ann Isaac
• Island Family Pharmacy Inc
• Island Family Pharmacy Inc
• Islands Edge Dental, LLC (Island's Edge Family Dentistry)
• Maryse Imbert Isma
• Anna IV, PA

• Primary Care Clinic/Center in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.