Jacksonville Children's Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

390 Issued in FL

Legal business name

JACKSONVILLE CHILDREN'S SURGERY CENTER, LLC

Practice address

3599 University Blvd S Ste 604
Jacksonville, FL 32216-4234

Phone

(904) 525-8629

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Devin Larsen

Title

Ceo

Phone

(208) 340-1840

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Ambulatory surgical center certification: CCN 10C0001129

Legal name

JACKSONVILLE CHILDREN'S SURGERY CENTER LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jul 16, 1990

Last certification

Jan 18, 2018

Ownership / control type

Proprietary

Facility address

3599 University Blvd South
Jacksonville, FL 32216

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1770620742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9709 LAKESIDE BLVD STE 350",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773811213",
            "telephone_number": "713-489-2198",
            "fax_number": "713-489-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3599 UNIVERSITY BLVD S STE 604",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164234",
            "telephone_number": "904-525-8629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE CHILDREN'S SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-340-1840"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "390",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "683",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacksonville Bilingual Speech Therapy LLC
• Jacksonville Brain & Spine PLLC
• Jacksonville Cardiovascular Center PL
• Jacksonville Carenow Urgent Care, LLC
• Jacksonville Center for Counseling, Inc.
• Jacksonville Childrens Surgery Center LLC
• Jacksonville Chiropractic & Acupuncture LLC (Total Health Clinic LLC)
• Jacksonville Chiropractic & Rehabilitation
• Jacksonville Chiropractic Associates, Inc (Wellspring Health and Sports Performance)
• Jacksonville Chiropractic Rehab and Wellness Center

• Ambulatory Surgical Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.

Verify at the official NPI Registry.