Active NPI
Maxcare Clinic LLC
- Health Service Clinic/Center
- Jacksonville, FL
National Provider Identifier
1730833633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Clinic/Center
- Legal business name
- MAXCARE CLINIC LLC
- Practice address
- 5547 Normandy Blvd
Jacksonville, FL 32205-6246 - Phone
- (904) 386-6785
- NPI assigned
- Feb 9, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ankur Parikh
- Title
- Owner
- Phone
- (904) 386-6785
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| Health Service Clinic/Center | 261QH0100X | Primary |
Addresses
Primary practice location
5547 Normandy Blvd
Jacksonville, FL 32205-6246
Mailing address
PO Box 600914
Saint Johns, FL 32260-0914
Phone (904) 386-6785
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2197687 | Maxcare Clinic | Certificate of waiver | Oct 26, 2026 |
National Provider Directory
National Provider Directory- Tax ID family
- Maxcare Clinic
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Hematology & Oncology Physician
- Saint Marys, GA
- NPI 1215828348
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Jacksonville, FL
- NPI 1790882082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644364800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1666742400000",
"number": "1730833633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 600914",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "322600914",
"telephone_number": "904-386-6785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5547 NORMANDY BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322056246",
"telephone_number": "904-386-6785"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAXCARE CLINIC LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-02-09",
"last_updated": "2022-10-26",
"certification_date": "2022-10-26",
"status": "A",
"authorized_official_last_name": "PARIKH",
"authorized_official_first_name": "ANKUR",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "904-386-6785"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QH0100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Health Service",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.