NPIMap

Organization Active NPI

Precision Imaging St. Augustine, LLC

  • Radiology Clinic/Center
  • St Augustine, FL
National Provider Identifier
1700130010
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
PRECISION IMAGING ST. AUGUSTINE, LLC
Practice address
1000 Plantation Island Dr S
Suite 1
St Augustine, FL 32080-3100
Phone
(904) 996-8100
Fax
(904) 996-8101
NPI assigned
Nov 8, 2012
Last updated
Dec 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Authorized official

Name
Josh Hammond
Title
Ceo
Phone
(904) 996-8100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X Primary

Addresses

Primary practice location

1000 Plantation Island Dr S
Suite 1
St Augustine, FL 32080-3100

Mailing address

PO Box 96418
Charlotte, NC 28296-0418
Phone (904) 996-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130416000169 FL Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 3375789464 Practice locations: St Augustine, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2056085Precision Imaging St Augustine1000 Plantation Island Dr Ste 1, Saint Augustine, FL 32080Certificate of waiverMar 20, 2027

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1000 Plantation Island Dr S
Ste 1
Saint Augustine, FL 32080
Phone (904) 471-9633

Practitioners & affiliated clinicians

Practitioners 30

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 30

NPI Registry JSON

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1700130010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 96418",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282960418",
            "telephone_number": "904-996-8100",
            "fax_number": "904-389-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PLANTATION ISLAND DR S",
            "address_2": "SUITE 1",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320803100",
            "telephone_number": "904-996-8100",
            "fax_number": "904-996-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION IMAGING ST. AUGUSTINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-08",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-996-8100"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.