Salud Primary Care LLC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

Legal business name

SALUD PRIMARY CARE LLC

Practice address

1126 University Blvd N Ste 3105
Jacksonville, FL 32211-8850

Phone

(904) 625-2644

NPI assigned

Mar 8, 2021

Organization subpart

No

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

Authorized official

Name

Johanna Russell, NP

Title

Owner

Phone

(904) 625-2644

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1615161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1730774142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 TINTAMARRE DR",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320921102",
            "telephone_number": "904-625-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 UNIVERSITY BLVD N STE 3105",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322118850",
            "telephone_number": "904-625-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALUD PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-08",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "JOHANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-625-2644",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Primary Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.