Organization Active NPI

Capstone Primary Care, LLC

  • Primary Care Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1952992794
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
CAPSTONE PRIMARY CARE, LLC
Practice address
2950 Halcyon LN Ste 302
Jacksonville, FL 32223-6690
Phone
(904) 503-7385
Fax
(904) 539-3031
NPI assigned
Feb 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Authorized official

Name
Mr. Jose Garcia, AUTONOMOUS APRNNPI 1629555834
Title
President
Phone
(904) 503-7385

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 Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

2950 Halcyon LN Ste 302
Jacksonville, FL 32223-6690

Mailing address

2950 Halcyon LN Ste 302
Jacksonville, FL 32223-6690
Phone (904) 503-7385

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210222000780 FL Part B Supplier - Clinic/Group Practice 9234544412 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, 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
10D2228718Capstone Primary Care2950 Halcyon Lane Ste 302, Jacksonville, FL 32223Certificate of waiverJun 29, 2027

National Provider Directory

National Provider Directory

Locations

2950 Halcyon Ln
Ste 302
Jacksonville, FL 32223
Phone (904) 503-7385

Practitioners & affiliated clinicians

Practitioners 1

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": "1612224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1952992794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 HALCYON LN STE 302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236690",
            "telephone_number": "904-503-7385",
            "fax_number": "904-539-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 HALCYON LN STE 302",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236690",
            "telephone_number": "904-503-7385",
            "fax_number": "904-539-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPSTONE PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-503-7385",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "AUTONOMOUS APRN"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 2, 2021; 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.