St Croix Family Medicine, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

2-14663-1L Issued in VI

Legal business name

ST CROIX FAMILY MEDICINE, LLC

Practice address

4500 Sunny Isle
Christiansted, VI 00820-5173

Phone

(340) 692-2600

Fax

(340) 692-2602

NPI assigned

Jan 4, 2012

Last updated

May 16, 2019By 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

Dr. Gemaine Diane Owen, M.D.NPI 1891819017

Title

Manager/Member

Phone

(340) 692-2600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VI

Enrollment records 1

Locations

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.

• Gemaine Diane Owen, MD

  • Family Medicine Physician
  • Christiansted, VI
  • NPI 1891819017
  Medicare reassignment NPD Authorized official
• Jewel Victoria Owen, PSY.D.

  • Clinical Psychologist
  • Kingshill, VI
  • NPI 1679554364
  NPD

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557964800000",
    "number": "1841560059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 2 BOX 10565",
            "address_2": "SUITE 107, THE VILLAGE MALL",
            "city": "KINGSHILL",
            "state": "VI",
            "postal_code": "008509604",
            "telephone_number": "340-692-2600",
            "fax_number": "340-692-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 SUNNY ISLE",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "008205173",
            "telephone_number": "340-692-2600",
            "fax_number": "340-692-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CROIX FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-04",
        "last_updated": "2019-05-16",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "GEMAINE",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "MANAGER/MEMBER",
        "authorized_official_telephone_number": "340-692-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VI",
            "license": "2-14663-1L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Frances Sobeck, M.A., BCBA
• Julie W Sommer, MSOT, OTR/L
• Darlenny Sotomayor
• Soul Health, Inc.
• Telisha Springer
• St Croix Vascular Surgery Associates LLC (Gregory D Casey MD FACS)
• St Croix Vision Center Inc (Vision Center)
• St. Croix Diagnostics, LLC
• St. Croix Eye Group, Inc.
• St. Croix Eye Institute, LLC

• Primary Care Clinic/Center in Christiansted, VI
• Providers in Christiansted, VI by specialty
• Primary Care Clinic/Center in U.S. Virgin Islands

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; 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.