NPIMap

Organization Active NPI

Express Family Care

  • Family Medicine Physician
  • Crescent City, FL
National Provider Identifier
1891034823
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
PA9101505 Issued in FL
Legal business name
EXPRESS FAMILY CARE
Practice address
300 S Main St
Crescent City, FL 32112-2729
Phone
(386) 698-1221
Fax
(386) 698-1514
NPI assigned
Feb 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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

Authorized official

Name
John Milanick, MD MPHNPI 1295704286
Title
Partner
Phone
(386) 698-1221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X PA9101505 FL Primary

Addresses

Primary practice location

300 S Main St
Crescent City, FL 32112-2729

Mailing address

PO Box 66
Palatka, FL 32178-0066
Phone (386) 698-1221

Other practice location 1

6100 Saint Johns Ave Ste 3
Palatka, FL 32177-6859
Phone (386) 530-4990

Other practice location 2

150 Southpark Blvd Ste 102A
St Augustine, FL 32086-5190
Phone (904) 342-5003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130910000771 FL Part B Supplier - Clinic/Group Practice 4385888551 Receives reassigned benefits from 12 practitioners
Practice locations: Crescent City, FL; Palatka, FL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2054325Express Family Care LLC300 S Main St, Crescent City, FL 32112Certificate of waiverFeb 18, 2027

National Provider Directory

National Provider Directory

Locations

6100 Saint Johns Ave
Ste 3
Palatka, FL 32177
Phone (386) 530-4990

6500 Crill Ave
Bldg 1
Palatka, FL 32177
Phone (386) 326-0575

150 Southpark Blvd
Ste 102A
Saint Augustine, FL 32086
Phone (904) 342-5003

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1891034823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321780066",
            "telephone_number": "386-698-1221",
            "fax_number": "386-698-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S MAIN ST",
            "city": "CRESCENT CITY",
            "state": "FL",
            "postal_code": "321122729",
            "telephone_number": "386-698-1221",
            "fax_number": "386-698-1514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6100 Saint Johns Ave Ste 3",
            "address_purpose": "LOCATION",
            "city": "Palatka",
            "state": "FL",
            "postal_code": "321776859",
            "country_code": "US",
            "telephone_number": "386-530-4990",
            "fax_number": "386-385-4826",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "150 Southpark Blvd Ste 102A",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865190",
            "country_code": "US",
            "telephone_number": "904-342-5003",
            "fax_number": "904-342-5550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EXPRESS FAMILY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-12",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "MILANICK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "386-698-1221",
        "authorized_official_credential": "MD MPH"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "PA9101505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crescent City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; 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.

Verify at the official NPI Registry.