ST VINCENTS MEDICAL CENTER INC (NPI# 1427005131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427005131 |
| Entity Type | Organization |
| Organization Name | ST VINCENTS MEDICAL CENTER INC |
| Other Organization Name | ST VINCENTS FAMILY MEDICINE CENTER |
| Practice Address |
2627 Riverside Ave Jacksonville FL 32204-4712 |
| Practice Telephone | 9043087372 |
| Mailing Telephone | 9043087372 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2010-03-26 |
| Authorized Official Name | GENE MIYAMOTO (COO) |
| Authorized Official Telephone | 9043081290 |
| Is Organization Subpart | Y |
| Parent Organization Name | ST VINCENTS MEDICAL CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 057339600 | 05 | |
| FL | BCBS | 99612 | 01 |
| Other Name | Type Code |
|---|---|
| St Vincents Family Medicine Center | 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 |
| 1134117575 | St Vincents Medical Center Inc | General Acute Care Hospital | 1 Shircliff Way, Jacksonville, FL 32204-4748 | 2005-10-10 |
| Street Address |
2627 RIVERSIDE AVE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-4712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770575052 | Belton Craig Ray | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4712 | 2005-08-22 |
| 1215549316 | Renee E Alten | Student in an Organized Health Care Education/Training Program | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-08-19 |
| 1114538634 | Faradia Pierre | Student in an Organized Health Care Education/Training Program | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-08-10 |
| 1841817772 | Kelsey Rhae Williams | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
| 1477170488 | Lisa Michelle Alley | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
| 1104443126 | Verniecea J Harris | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
| 1508483421 | Lacey J Rokita | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
| 1497372320 | Annika Tabassum | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
| 1023635943 | Yvonne Nyakio Kamau | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-26 |
| 1114542859 | Olivia Michelle Bullock | Student in an Organized Health Care Education/Training Program | 2627 Riverside Ave, Jacksonville, FL 32204-4717 | 2020-06-09 |
| 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 | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1023628351 | Ase Telehealth Inc | Clinic/Center | 5851 Timuquana Rd Ste 104, Jacksonville, FL 32210-7890 | 2020-08-02 |
| 1659840866 | Care4usmd | Clinic/Center | 14866 Old Saint Augustine Rd Ste 113, Jacksonville, FL 32258-2611 | 2018-11-16 |
| 1598278707 | Sunbelt Visiting Primary Care LLC | Clinic/Center | 8833 Perimeter Park Blvd Ste 901, Jacksonville, FL 32216-1113 | 2017-11-09 |
| 1881084390 | Jm Family Enterprises, Inc. | Clinic/Center | 1851 Talleyrand Ave, Jacksonville, FL 32206-5473 | 2015-02-04 |
| 1366790404 | Healthy U Medical Clinic LLC | Clinic/Center | 7208 Highway 238, Jacksonville, OR 97530-9131 | 2012-08-21 |
| 1154696417 | Duc Le Nguyen Md Pa | Clinic/Center | 803 Rosselle St, Jacksonville, FL 32204-2943 | 2012-03-19 |
| 1265704530 | Paul D. Zawatsky, Md, Pa | Clinic/Center | 10609 Old Saint Augustine Rd, Suite 4, Jacksonville, FL 32257-1164 | 2012-02-02 |
| 1619287182 | Down East Family Medicine, Pllc | Clinic/Center | 306 Brynn Marr Road, Jacksonville, NC 28546-7023 | 2010-10-18 |
| 1194033043 | Peoples Medical Centers Primary Care Inc | Clinic/Center | 4114 Sunbeam Rd Ste 102, Jacksonville, FL 32257-8870 | 2010-09-14 |
| 1669797700 | Goshen Medical Center Incorporated | Clinic/Center | 1200 Hargett St, Jacksonville, NC 28540-5933 | 2010-04-01 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
Please comment or provide details below to improve the information on ST VINCENTS MEDICAL CENTER INC.
| 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.