NPIMap

Organization Active NPI

St. Vincent's First Care

  • Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1871924258
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
EXEMPT HOSPITAL OWNE Issued in FL
Legal business name
ST. VINCENT'S FIRST CARE
Practice address
5501 Roosevelt Blvd
Jacksonville, FL 32244-2345
Phone
(904) 379-1203
Fax
(904) 379-9282
NPI assigned
Dec 10, 2013
Last updated
Dec 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Authorized official

Name
Mr. Mark Reddinger
Title
Chief Financial Officer
Phone
(904) 738-5177

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X EXEMPT HOSPITAL OWNE FL Primary

Addresses

Primary practice location

5501 Roosevelt Blvd
Jacksonville, FL 32244-2345

Mailing address

8323 Ramona Blvd W
Jacksonville, FL 32221-1386
Phone (904) 379-1203

Other identifiers 3

IdentifierTypeStateIssuer
007293401MedicaidFL
040JOtherFLBLUE CROSS FLORIDA
007294300MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
St Vincents First Care LLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

5501 Roosevelt Blvd
Jacksonville, FL 32244
Phone (904) 308-7372

8323 Ramona Blvd W
Jacksonville, FL 32221

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1386633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386633600000",
    "number": "1871924258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8323 RAMONA BLVD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322211386",
            "telephone_number": "904-379-1203",
            "fax_number": "904-379-9282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 ROOSEVELT BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322442345",
            "telephone_number": "904-379-1203",
            "fax_number": "904-379-9282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. VINCENT'S FIRST CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-10",
        "last_updated": "2013-12-10",
        "status": "A",
        "authorized_official_last_name": "REDDINGER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "904-738-5177",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "EXEMPT HOSPITAL OWNE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007293401",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS FLORIDA",
            "identifier": "040J",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007294300",
            "state": "FL"
        }
    ],
    "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 Dec 10, 2013; 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.