NPIMap

Organization Active NPI

Avecina Medical, PA

  • Urgent Care Clinic/Center
  • St Augustine, FL
National Provider Identifier
1740997865
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
AVECINA MEDICAL, PA
Practice address
30 Epic Blvd Ste 100
St Augustine, FL 32086-6603
Phone
(904) 217-3881
Fax
(904) 342-2368
NPI assigned
Oct 28, 2022
Organization subpart
Yes
Parent organization
AVECINA MEDICAL, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Amanda Moretti Kight
Title
Billing Manager
Phone
(904) 367-3372

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

30 Epic Blvd Ste 100
St Augustine, FL 32086-6603

Mailing address

4815 Sweetgrass PL Ste 201
Jacksonville, FL 32224-0131
Phone (904) 367-3372

National Provider Directory

National Provider Directory
Part of
Avecina Medical PA

Locations

3600 SW Archer Rd
Ste A-1
Gainesville, FL 32608
Phone (352) 240-6048

Practitioners & affiliated clinicians

Practitioners 6

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": "1666915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1740997865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4815 SWEETGRASS PL STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322240131",
            "telephone_number": "904-367-3372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 EPIC BLVD STE 100",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866603",
            "telephone_number": "904-217-3881",
            "fax_number": "904-342-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVECINA MEDICAL, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AVECINA MEDICAL, PA",
        "enumeration_date": "2022-10-28",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "MORETTI KIGHT",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "904-367-3372"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "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 Jul 29, 2024; 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.