ST VINCENTS AMBULATORY CARE INC (NPI# 1417987124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417987124 |
| Entity Type | Organization |
| Organization Name | ST VINCENTS AMBULATORY CARE INC |
| Practice Address |
2 Shircliff Way Suite 600 Jacksonville FL 32204-4742 |
| Mailing Address |
Po Box 848457 Boston MA 02284-8457 |
| Practice Telephone | 9043086769 |
| Practice Fax Number | 9043084072 |
| Mailing Telephone | 9043087959 |
| Mailing Fax Number | 9043087938 |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2012-11-20 |
| Authorized Official Name | MR. MOODY L CHISHOLM JR. (CEO) |
| Authorized Official Telephone | 9043088446 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
FL | Allopathic & Osteopathic Physicians | |
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
FL | Allopathic & Osteopathic Physicians | |
| N | 207T00000X | Neurological Surgery | FL | Allopathic & Osteopathic Physicians | |
| N | 207V00000X | Obstetrics & Gynecology | FL | Allopathic & Osteopathic Physicians | |
| N | 208600000X | Surgery | FL | Allopathic & Osteopathic Physicians | |
| N | 207R00000X | Internal Medicine | FL | Allopathic & Osteopathic Physicians | |
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
FL | Allopathic & Osteopathic Physicians | |
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 276587000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558344978 | St Vincents Ambulatory Care Inc | Nurse Practitioner | 551616 Us Highway 1, Hilliard, FL 32046-8281 | 2005-11-21 |
| Street Address |
2 SHIRCLIFF WAY SUITE 600 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-4742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972508356 | Suprith Badarinath | Internal Medicine | 2 Shircliff Way, Ste 800, Jacksonville, FL 32204-4751 | 2005-06-14 |
| 1841656105 | Rita Marie Border | Nurse Practitioner | 2 Shircliff Way, #300, Jacksonville, FL 32204-4753 | 2016-01-01 |
| 1295128817 | Alexandra Eleanor Michaelis | Nurse Practitioner | 2 Shircliff Way, Suite 700 Depaul Bldg., Jacksonville, FL 32204-4763 | 2015-03-05 |
| 1538558028 | Carole Faria | Registered Nurse | 2 Shircliff Way, Suite 900, Jacksonville, FL 32204-4753 | 2015-01-21 |
| 1609265107 | Teresa Braddy | Registered Nurse | 2 Shircliff Way, Suite 900, Jacksonville, FL 32204-4753 | 2015-01-21 |
| 1235533829 | Heekin Clinic LLC | Orthopaedic Surgery | 2 Shircliff Way, Ste 605 Depaul Building, Jacksonville, FL 32204-4753 | 2014-10-10 |
| 1851710404 | Juan Chique Figueroa | Internal Medicine | 2 Shircliff Way, Suite 700 Depaul Bldg., Jacksonville, FL 32204 | 2014-04-10 |
| 1295151348 | Harris, Wilcox & Donovan Pa | Ophthalmology | 2 Shircliff Way, Suite 120, Jacksonville, FL 32204-4753 | 2014-03-13 |
| 1568800613 | Sara Marie Preston | Nurse Practitioner | 2 Shircliff Way, Ste 700 Depaul Bldg., Jacksonville, FL 32204-4763 | 2013-06-11 |
| 1851735187 | Lori Elizabeth Jones-taylor | Pharmacist | 2 Shircliff Way, Jacksonville, FL 32204-4753 | 2013-04-17 |
| 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 | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1013436252 | Ryan N Pafford | Neurological Surgery | University of Florida Health, 580 West 8th Street, Tower 1, 8th Floor, Jacksonville, FL 32209 | 2017-09-19 |
| 1144586116 | Anil Kumar Roy | Neurological Surgery | 800 Prudential Dr Fl B11, Jacksonville, FL 32207-8202 | 2012-04-04 |
| 1437487709 | Andrew Brian Shaw | Neurological Surgery | 800 Prudential Dr Ste 1100, Jacksonville, FL 32207-8202 | 2009-11-25 |
| 1790965325 | Stephen Scott Scibelli | Neurological Surgery | 3627 University Blvd S Suite 355, Memorial Neurosurgery Group, Jacksonville, FL 32216 | 2007-11-12 |
| 1477754513 | Michael J Petr | Neurological Surgery | 7807 Baymeadows Rd E Ste 208, Jacksonville, FL 32256-9666 | 2007-05-29 |
| 1063500015 | Amos Olabisi Dare | Neurological Surgery | 544 Cesery Blvd, Suite 310, Jacksonville, FL 32211 | 2006-10-11 |
| 1104911601 | Neurosurgery Consultants Pa | Neurological Surgery | 215 Station Street, Jacksonville, NC 28546 | 2006-10-03 |
| 1255373528 | Kaveh Barami | Neurological Surgery | 3627 University Boulevard South, Suite 355, Jacksonville, FL 32216-8030 | 2006-06-12 |
| 1295773943 | Sean Hsu | Neurological Surgery | 215 Station St, Jacksonville, NC 28546-6304 | 2006-06-03 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
Please comment or provide details below to improve the information on ST VINCENTS AMBULATORY CARE 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.