Active NPI
JK Health Systems, LLC
Doing business as 1 Primary Care
- Family Medicine Physician
- Orange Park, FL
National Provider Identifier
1851146500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- JK HEALTH SYSTEMS, LLC
- Doing business as
- 1 Primary Care
- Practice address
- 2140 Kingsley Ave Ste 2
Orange Park, FL 32073-5129 - Phone
- (999) 999-9999
- NPI assigned
- Apr 17, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John Distefano
- Title
- Business Manager
- Phone
- (352) 317-3214
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
2140 Kingsley Ave Ste 2
Orange Park, FL 32073-5129
Mailing address
1548 Maple Leaf LN
Fleming Island, FL 32003-8225
Phone (904) 752-0215
Other names 1
- 1 Primary Care
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2308129 | 1 Primary Care | Certificate of waiver | Jul 22, 2028 |
National Provider Directory
National Provider DirectoryLocations
2140 Kingsley Ave
Ste 2
Orange Park, FL 32073
Phone (904) 375-1963
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713312000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1738886400000",
"number": "1851146500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1548 MAPLE LEAF LN",
"city": "FLEMING ISLAND",
"state": "FL",
"postal_code": "320038225",
"telephone_number": "904-752-0215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2140 KINGSLEY AVE STE 2",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320735129",
"telephone_number": "999-999-9999"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JK HEALTH SYSTEMS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-04-17",
"last_updated": "2025-02-07",
"certification_date": "2025-02-07",
"status": "A",
"authorized_official_last_name": "DISTEFANO",
"authorized_official_first_name": "JOHN",
"authorized_official_title_or_position": "BUSINESS MANAGER",
"authorized_official_telephone_number": "352-317-3214"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "1 Primary Care",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "1 Primary Care",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.