First Coast Medical Associates LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

FIRST COAST MEDICAL ASSOCIATES LLC

Practice address

13241 Bartram Park Blvd Unit 413
Jacksonville, FL 32258-5237

Phone

(904) 400-6800

Fax

(904) 400-6801

NPI assigned

Aug 21, 2014

Organization subpart

No

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

Authorized official

Name

Ravi K Kancha, MDNPI 1982730214

Title

Docto

Phone

(904) 400-6800

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 5

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

• Ravi Kumar Kancha, MD

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1982730214
  Medicare reassignment NPD Authorized official
• Christina M Franklin, ARNP

  • Family Nurse Practitioner
  • Orlando, FL
  • NPI 1891299228
  Medicare reassignment NPD
• Jessica Leigh Lloyd, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1609289255
  Medicare reassignment NPD
• Annamarie Loyola, ARNP

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1184117574
  Medicare reassignment NPD
• Julian Bungubung Martin

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1629453246
  Medicare reassignment NPD

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1760881163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 413",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585237",
            "telephone_number": "904-400-6800",
            "fax_number": "904-400-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13241 BARTRAM PARK BLVD UNIT 413",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585237",
            "telephone_number": "904-400-6800",
            "fax_number": "904-400-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST MEDICAL ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "KANCHA",
        "authorized_official_first_name": "RAVI",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DOCTO",
        "authorized_official_telephone_number": "904-400-6800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "FL",
            "license": "ME98044",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "277639100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• First Coast Hospitalist P L
• First Coast Imaging LLC
• First Coast Infectious Disease Consultants LLC
• First Coast Laboratories
• First Coast LTC Inc
• First Coast Medical Center Inc
• First Coast Medicine PLLC
• First Coast Midwifery Services LLC
• First Coast Nephrology Inc
• First Coast Orthopedic Associates LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; 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.