NPIMap

Organization Active NPI

St. Vincent's Healthcare

  • Acute Care Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1811246390
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
214209 Issued in NC
Legal business name
ST. VINCENT'S HEALTHCARE
Practice address
3 Shircliff Way Ste 714
Jacksonville, FL 32204-4786
Phone
(904) 308-2006
NPI assigned
Aug 30, 2012
Last updated
Aug 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Authorized official

Name
George Ann Allen
Title
Credentialing Coordinator
Phone
(904) 296-5690

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 214209 NC
Acute Care Nurse Practitioner 363LA2100X 214209 NC Primary

Addresses

Primary practice location

3 Shircliff Way Ste 714
Jacksonville, FL 32204-4786

Mailing address

1303 Whispering Oak LN
Durham, NC 27704-5097
Phone (919) 251-9706

National Provider Directory

National Provider Directory
Tax ID family
St Vincents Ambulatory Care Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1 Shircliff Way
Ste 714
Jacksonville, FL 32204

NPI Registry JSON

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

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346284800000",
    "number": "1811246390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 WHISPERING OAK LN",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277045097",
            "telephone_number": "919-251-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 SHIRCLIFF WAY STE 714",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044786",
            "telephone_number": "904-308-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT'S HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-30",
        "last_updated": "2012-08-30",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "GEORGE ANN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "904-296-5690"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NC",
            "license": "214209",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "214209",
            "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 Aug 30, 2012; 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.