ST VINCENTS MEDICAL CENTER INC (NPI# 1134117575) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134117575 |
| Entity Type | Organization |
| Organization Name | ST VINCENTS MEDICAL CENTER INC |
| Other Organization Name | ST VINCENTS MEDICAL CENTER RIVERSIDE |
| Practice Address |
1 Shircliff Way Jacksonville FL 32204-4748 |
| Mailing Address |
4205 Belfort Road Jab # 4020 Jacksonville FL 32216 |
| Practice Telephone | 9043087300 |
| Mailing Telephone | 9044506020 |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2019-03-19 |
| Authorized Official Name | DONNIE ROMINE (COO SVHC/PRESIDENT SVR) |
| Authorized Official Telephone | 9043081290 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 4376 | FL | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 010073100 | 05 | |
| FL | BCBS | 108 | 01 |
| Other Name | Type Code |
|---|---|
| Ascension St. Vincent's Riverside | Doing Business As Name - Organization |
| St Vincents Medical Center Riverside | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629318993 | St Vincents Medical Center Inc | Psychiatric Unit | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2013-02-25 |
| 1669556072 | St Vincents Medical Center Inc | Clinical Medical Laboratory | 4203 Belfort Rd, Suite 106, Jacksonville, FL 32216-1409 | 2006-10-24 |
| 1427005131 | St Vincents Medical Center Inc | Clinic/Center | 2627 Riverside Ave, Jacksonville, FL 32204-4712 | 2006-05-28 |
| Street Address |
1 SHIRCLIFF WAY |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-4748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295738367 | Emergency Medical Specialists of Jacksonville | Emergency Medicine | 1 Shircliff Way, Jacksonville, FL 32204-4778 | 2005-05-23 |
| 1033725858 | Kathleen Fry | Registered Nurse | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2020-09-17 |
| 1841808912 | Jade Leanne Nelson Donegal | Registered Nurse | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2020-07-15 |
| 1124642731 | Arielle Christina Griffin | Social Worker | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2020-05-31 |
| 1639709199 | Tom Wonneberger | Physician Assistant | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2020-01-23 |
| 1114557162 | Janet Marie Goodson | Registered Nurse | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2020-01-17 |
| 1487291472 | Megan Elaine Karbowski | Anesthesiologist Assistant | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2019-12-09 |
| 1124663182 | Douglas Earl Stilwell | Nurse Practitioner | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2019-11-14 |
| 1316588908 | Andrew Griffin | Anesthesiologist Assistant | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2019-10-04 |
| 1194366278 | Laura Ann Kereczman | Nurse Practitioner | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2019-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528683257 | Gainesville Vamc | General Acute Care Hospital | 2080 Child St Bldg 200h, Jacksonville, FL 32214-5005 | 2020-06-09 |
| 1922487974 | Shemaka James | General Acute Care Hospital | 5202 Wabash Blvd, Jacksonville, FL 32254-1366 | 2015-05-22 |
| 1962893149 | Michelle Porter | General Acute Care Hospital | 402 Stagecoach Dr, Jacksonville, NC 28546-8663 | 2015-02-10 |
| 1811246390 | St. Vincent's Healthcare | General Acute Care Hospital | 3 Shircliff Way Ste 714, Jacksonville, FL 32204-4786 | 2012-08-30 |
| 1255570974 | Svila Skin Solutions | General Acute Care Hospital | 1936 San Marco Blvd, Jacksonville, FL 32207-3286 | 2009-02-19 |
| 1760644009 | Walter Ruday Jr. | General Acute Care Hospital | 2748 University Blvd W, Jacksonville, FL 32217-2123 | 2008-06-27 |
| 1386801116 | Abdolreza Mohammadian | General Acute Care Hospital | 1536 N.jefferson Street, Va Outpatient Clinic, Jacksonville, FL 32209-0000 | 2008-05-20 |
| 1861451114 | Allegiance Hospital of North Little Rock, LLC | General Acute Care Hospital | 1400 Braden St., Jacksonville, AR 72076 | 2006-03-23 |
| 1730697350 | Jacksonville Hospital LLC | General Acute Care Hospital | 501 S Ragsdale St, Jacksonville, TX 75766-2434 | 2018-01-17 |
| 1144735069 | Brynn Marr Hospital - Navy Resource Sharing | General Acute Care Hospital | 192 Village Dr, Jacksonville, NC 28546-7238 | 2017-12-14 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.