St. Johns Bluff Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME060414 Issued in FL

Legal business name

ST. JOHNS BLUFF FAMILY PRACTICE

Practice address

3690 Saint Johns Bluff Rd S
Jacksonville, FL 32224-2616

Phone

(904) 564-4343

Fax

(904) 224-7051

NPI assigned

May 7, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Merrianne Renee Rust

Title

Office Manager

Phone

(904) 564-4343

Specialties & licenses 1

Addresses

Practitioners 2

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.

• Charles A Rust, M.D.

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1457435752
  NPD (past)
• Richard Donald Wetmore, M.D.

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1982769295
  NPD (past)

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760695852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3690 SAINT JOHNS BLUFF RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242616",
            "telephone_number": "904-564-4343",
            "fax_number": "904-224-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3690 SAINT JOHNS BLUFF RD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242616",
            "telephone_number": "904-564-4343",
            "fax_number": "904-224-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHNS BLUFF FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUST",
        "authorized_official_first_name": "MERRIANNE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "904-564-4343",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME060414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Vincents Pathology Associates PA
• St Vincents Physician Enterprise Inc (St Vincents Primary Care)
• Matthew Tyler St. George, RD
• Teresa Marie St. John, PT
• St. John's Integrated Health, Inc.
• St. Johns Interventional and Vascular Institute
• St. Johns River Rural Health Network
• St. Johns Vein Center, Inc.
• St. Levon Haven, LLC
• Adrienne St. Louis

• Family Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.