County of St Johns Board of County Commissioners

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

2664 Issued in FL

Legal business name

COUNTY OF ST JOHNS BOARD OF COUNTY COMMISSIONERS

Practice address

3149 N Ponce de Leon Blvd
Suite 9
St Augustine, FL 32084-8601

Phone

(904) 209-1700

Fax

(904) 209-1706

NPI assigned

Aug 30, 2005

Organization subpart

No

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

Authorized official

Name

Jeff Prevatt

Title

Assistant Fire Chief

Phone

(904) 209-1713

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• St. Johns County Fire Rescue Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

St Johns County Board of County Commissioners4 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.

• St Johns County Board of County Commissioners

  • Mental Illness Community Based Residential Treatment Facility
  • St Augustine, FL
  • NPI 1326037813
  NPD tax ID
• St Johns County Board of County Commissioners

  • Community/Behavioral Health Agency
  • St Augustine, FL
  • NPI 1508855560
  NPD tax ID
• St Johns County Board of County Commissioners

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Augustine, FL
  • NPI 1538158886
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James Berwick, LCSW

  • Clinical Social Worker
  • St Augustine, FL
  • NPI 1265421259
  Medicare reassignment NPD
• Peter Richard Accorti, ARNP

  • Nurse Practitioner
  • Pensacola, FL
  • NPI 1801394291
  NPD (past)

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1720071343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3149 N PONCE DE LEON BLVD",
            "address_2": "SUITE 9",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320848601",
            "telephone_number": "904-209-1700",
            "fax_number": "904-209-1706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3149 N PONCE DE LEON BLVD",
            "address_2": "SUITE 9",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320848601",
            "telephone_number": "904-209-1700",
            "fax_number": "904-209-1706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF ST JOHNS BOARD OF COUNTY COMMISSIONERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-30",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "PREVATT",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "ASSISTANT FIRE CHIEF",
        "authorized_official_telephone_number": "904-209-1713"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "FL",
            "license": "2664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08948000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Johns County Fire Rescue",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Leslie Danielle Couden Dileo, LMHC
• Abigail Coulson
• Kimberly Council, SLP
• Counseling Associates Clinic
• Dalana Countryman-Benjamin, RBT
• Lindsey Courson, RN
• Samantha Courson
• Laura Cowart, M.S.
• David Wesley Cowling, DMD
• Cox Chiropractic PL

• Land Ambulance in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Land Ambulance in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.