NPIMap

Organization Active NPI

Amelia Express Care, LLC

  • Primary Care Clinic/Center
  • Fernandina Beach, FL
National Provider Identifier
1952701435
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
OS10149 Issued in FL
Legal business name
AMELIA EXPRESS CARE, LLC
Practice address
1987 S 8TH St
Fernandina Beach, FL 32034-3071
Phone
(904) 624-7003
Fax
(904) 212-1284
NPI assigned
Sep 3, 2014
Last updated
Jun 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Authorized official

Name
Jacob T Logsdon, PANPI 1386978682
Title
Manager
Phone
(904) 624-7003

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
Primary Care Clinic/Center 261QP2300X OS10149 FL Primary

Addresses

Primary practice location

1987 S 8TH St
Fernandina Beach, FL 32034-3071

Mailing address

1987 S 8TH St
Fernandina Beach, FL 32034-3071
Phone (904) 624-7003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150623000855 FL Part B Supplier - Clinic/Group Practice 8628389244 Receives reassigned benefits from 17 practitioners
Practice locations: Fernandina Beach, FL

National Provider Directory

National Provider Directory

Locations

1987 S 8th St
Fernandina Beach, FL 32034
Phone (904) 624-7003

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1952701435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1987 S 8TH ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343071",
            "telephone_number": "904-624-7003",
            "fax_number": "904-212-1284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1987 S 8TH ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343071",
            "telephone_number": "904-624-7003",
            "fax_number": "904-212-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMELIA EXPRESS CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-03",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "LOGSDON",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "904-624-7003",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "OS10149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.