Organization Active NPI

Medone, PLLC

Doing business as MedOne at Saint Augustine

  • Urgent Care Clinic/Center
  • St Augustine, FL
National Provider Identifier
1942706130
Registry record updated Aug 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MEDONE, PLLC
Doing business as
MedOne at Saint Augustine
Practice address
841 S Ponce de Leon Blvd Ste 4&5
Saint Augustine, FL 32084-6007
Phone
(352) 694-6331
Fax
(352) 694-6338
NPI assigned
Apr 5, 2018
Last updated
Aug 12, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDONE, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 12, 2026

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

Authorized official

Name
Crystal Burnham
Title
Admin
Phone
(352) 694-6331

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

841 S Ponce de Leon Blvd Ste 4&5
Saint Augustine, FL 32084-6007

Mailing address

841 S Ponce de Leon Blvd Ste 4
St Augustine, FL 32084-6008
Phone (904) 907-2229

Other practice location 1

6160 SW Highway 200 Unit 119
Ocala, FL 34476-8307
Phone (352) 694-6331

Other identifiers 1

IdentifierTypeStateIssuer
ME74255OtherFLMEDICAL LICENSE

Other names 1

  • MedOne at Saint Augustine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120502000356 FL Part B Supplier - Clinic/Group Practice 0648432997 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ocala, FL; Saint Augustine, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Medone PLLC2 organizations share this tax ID, including this one
Part of
Medone PLLC

Other organizations with this tax ID 1

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

Locations

841 S Ponce de Leon Blvd
Ste 45
Saint Augustine, FL 32084
Phone (352) 694-6331

841 S Ponce de Leon Blvd
St Augustine, FL 32084

841 S Ponce de Leon Blvd
Ste 4
St Augustine, FL 32084
Phone (904) 907-2228

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786492800000",
    "number": "1942706130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 S PONCE DE LEON BLVD STE 4",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846008",
            "telephone_number": "904-907-2229",
            "fax_number": "904-342-8902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 S PONCE DE LEON BLVD STE 4&5",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320846007",
            "telephone_number": "352-694-6331",
            "fax_number": "352-694-6338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6160 SW Highway 200 Unit 119",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344768307",
            "country_code": "US",
            "telephone_number": "352-694-6331",
            "fax_number": "352-694-6338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDONE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDONE, PLLC",
        "enumeration_date": "2018-04-05",
        "last_updated": "2026-08-12",
        "certification_date": "2026-08-12",
        "status": "A",
        "authorized_official_last_name": "BURNHAM",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "352-694-6331"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME74255",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedOne at Saint Augustine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MedOne at Saint Augustine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; 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.