Organization Active NPI

OBGYN Associates of St Augustine PA

  • Obstetrics & Gynecology Physician
  • St Augustine, FL
National Provider Identifier
1659337756
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
0066572 Issued in FL
Legal business name
OBGYN ASSOCIATES OF ST AUGUSTINE PA
Practice address
300 Health Park Blvd
Ste 3002
St Augustine, FL 32086
Phone
(904) 819-1500
Fax
(904) 810-1023
NPI assigned
Apr 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Authorized official

Name
Susan Yarian, MD
Title
President
Phone
(904) 819-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 0066572 FL Primary

Addresses

Primary practice location

300 Health Park Blvd
Ste 3002
St Augustine, FL 32086

Mailing address

300 Health Park Blvd
Ste 3002
St Augustine, FL 32086
Phone (904) 819-1500

Other identifiers 1

IdentifierTypeStateIssuer
264245000MedicaidFL

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1659337756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 HEALTH PARK BLVD",
            "address_2": "STE 3002",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "32086",
            "telephone_number": "904-819-1500",
            "fax_number": "904-810-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HEALTH PARK BLVD",
            "address_2": "STE 3002",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "32086",
            "telephone_number": "904-819-1500",
            "fax_number": "904-810-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBGYN ASSOCIATES OF ST AUGUSTINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-26",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "YARIAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-819-1500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "0066572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "264245000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Dec 3, 2007; 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.