NPIMap

Organization Active NPI

St Vincent'S Full Service Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1932686151
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
ST VINCENT'S FULL SERVICE URGENT CARE, LLC
Practice address
5501 Roosevelt Blvd
Jacksonville, FL 32244-2345
Phone
(904) 683-9662
Fax
(904) 683-9640
NPI assigned
Jul 20, 2018
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Andrea Mendoza
Title
Chief Revenue Cycle Specialists
Phone
(904) 450-6045

Corporate family (same tax ID) 10

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

National Provider Directory

National Provider Directory
Tax ID family
St Vincents Full Service Ur (11 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

NPPES NPI Registry

Primary practice location

5501 Roosevelt Blvd
Jacksonville, FL 32244-2345

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
007294301MedicaidFL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 20, 2018.

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1932686151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623"
        },
        {
            "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": "904-683-9662",
            "fax_number": "904-683-9640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST VINCENT'S FULL SERVICE URGENT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CHIEF REVENUE CYCLE SPECIALISTS",
        "authorized_official_telephone_number": "904-450-6045"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007294301",
            "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 Jul 20, 2018; 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.